Superior Mesenteric Artery Syndrome: A Rare Mimic of Common Causes of Upper Gastrointestinal Obstruction (original) (raw)
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Superior mesenteric artery syndrome as a rare cause of duodenal obstruction
Surgical Practice, 2007
Superior mesenteric artery syndrome is a rare cause of duodenal obstruction. The syndrome can present as acute small bowel obstruction or intermittent compression symptoms such as postprandial epigastric pain, fullness or vomiting. The obstruction is caused by compression of the third part of the duodenum against the posterior structures by the narrow-angled superior mesenteric artery. The diagnosis is easily confused with gastric outlet obstruction or proximal small bowel obstruction. A high index of clinical suspicion is crucial for diagnosis and computed tomography provides confirmatory evidence. We report two cases of superior mesenteric artery syndrome and a review of the literature for this condition.
Superior Mesenteric Artery Syndrome: An Unusual Cause Of Duodenal Obstruction
VITAE Academia …
Superior mesenteric artery (SMA) arising from aorta at the level of first lumbar vertebra usually takes an angular downward course from ventral surface of aorta. It is through this vascular angle that the 3rd part of duodenum passes at the level of 4th lumbar vertebra. Fat and lymphatics around SMA maintains the angle at 25° to 60° with a mean of 45 0 and provide protection against duodenal compression. In Superior Mesenteric Artery Syndrome, the SMA-aorta angle in narrowed down to 7° to 22° with a mean of 8 0 leading to entrapment of the transverse part of duodenum between the artery and the vertebral column and aorta with resultant partial or complete duodenal obstruction. We report a case of Superior Mesenteric Artery Syndrome which was diagnosed by CECT abdomen. Duodeno-jejunostomy was done to treat this condition.
Superior Mesenteric Artery Syndrome: A Forgotten Cause of Duodenal Obstruction
Cureus, 2020
Superior mesenteric artery (SMA) syndrome has been described in medical literature as a rare cause of duodenal occlusion. It has a varied presentation, with distressing gastrointestinal symptoms such as nausea, abdominal pain, and further weight loss. Several conditions contribute to duodenal obstruction in SMA syndrome. We present a case of SMA syndrome in a patient with malignant breast cancer who presented with sudden onset of severe nausea and voluminous vomiting. Various imaging studies revealed a distended proximal intestine with a transition point in the third part of the duodenum. The patient was managed conservatively with nasogastric decompression and fluid electrolyte management, leading to symptomatic relief.
A rare cause of duodenal obstruction: Superior mesenteric artery syndrome
International Journal of Case Reports and Images, 2015
International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties. Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. IJCRI publishes Review Articles, Case Series, Case Reports, Case in Images, Clinical Images and Letters to Editor.
International Surgery Journal, 2019
Superior mesenteric artery (SMA) syndrome (also known as Wilkie’s syndrome) is an unusual cause of proximal intestinal obstruction, attributable to vascular compression of the third part of duodenum between the superior mesenteric artery and the abdominal aorta due to acute angulation of SMA. It is a life threatening disease as it poses a diagnostic dilemma and often diagnosed by exclusion of other causes. It is an acquired disorder and is commonly due to loss of fatty tissue as a result of a variety of debilitating conditions. We report a case of SMA syndrome in a 23 year young asthenic female patient, with a long history of recurrent abdominal pain, epigastric fullness, voluminous vomiting, and weight loss. Symptoms persisted for 1 year and the patient underwent extensive investigations, but to no avail. Thereafter she developed proximal intestinal obstruction, which unravelled her diagnosis. Abdominal examination revealed epigastric fullness, tenderness and hyper peristaltic bowe...
Superior Mesenteric Artery Syndrome: Diagnosis and Management
PubMed, 2017
Superior mesenteric artery syndrome is a life-threatening rare acquired upper gastrointestinal disorder due to mechanical compression of third part of duodenum by the acute angulation of Superior mesenteric artery, leading to obstruction. Acute loss of intervening mesenteric fat as a result of a variety of debilitating conditions is believed to be the etiologic factor causing the reduced aortomesenteric angle. Abdominal CT angiography showed the dilatation of second part of duodenum and vascular compression of the proximal third part of the duodenum between the aorta and superior mesenteric artery. We report a case of 15 year old young boy who presented with recurrent postprandial pain in the epigastric region, accompanied by epigastric fullness, nausea, postprandial bilious vomiting and weight loss. When conservative measures were ineffective, laparoscopic retrocolic duodenojejunostomy, side to side anastomosis, was performed in the patient to relieve the obstruction. This case report is unusual as it is concerned with the description of a rare disease entity and its radiological appearances for early preoperative diagnosis, better understanding and management of the disease are discussed in the pertinent light of literature.
Superior Mesenteric Artery Syndrome: Clinical and Radiological Considerations
Surgery Research and Practice, 2015
Background. Superior mesenteric artery (SMA) syndrome is a rare condition of duodenal obstruction, caused by the overlying SMA.Aim. To report on our experience with the management of SMA syndrome, drawing the attention to its existence.Material and Methods. We reviewed our records to identify cases diagnosed with SMA syndrome, in the period from October 1995 to January 2012.Results. Seven patients were identified, one male and six females. Their mean age was 17.1 years. Vomiting and abdominal pain were the presenting complaints in all patients and history of weight loss was present in six of them. In no patient was the diagnosis suspected initially on clinical grounds. Only after radiological investigations was the diagnosis declared. Radiology took the form of gastrografin/barium meal only in four patients and both gastrografin/barium meal and computerized tomography scan in the remaining three. Four patients responded to medical treatment and surgery was performed in the remaining...
Superior Mesenteric Artery Syndrome: A Classic Presentation of a Rare Entity
Cureus, 2020
A 32-year-old female with a past medical history of constipation (predominant irritable bowel syndrome (IBS) and gastro-esophageal reflux disease (GERD)) presented with a complaint of pain in the lower abdomen. She lost 20 pounds in three months with a current body mass index (BMI) of 19.5 kg/m2 (ref: normal level 18.5-24.9). Computed tomography (CT) of the abdomen with contrast showed very little intra-abdominal fat, enlarged proximal duodenum, and decreased aorto-mesenteric angle of 15.40 suggestive of superior mesenteric artery (SMA) syndrome. Per general surgery, the patient was managed conservatively: initially Nil Per Os (NPO), slowly transitioned to a clear liquid diet, soft diet, and solid diet. She tolerated the diet, improved clinically, and was discharged home.