Emergency Department Presentation of Superior Mesenteric Artery Syndrome: Two Cases in Marine Corps Recruits

Rudinsky, Sherri L; Matteucci, Michael J.

doi:10.1016/j.jemermed.2008.07.029

Cited by 12 publications

(10 citation statements)

References 13 publications

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“…Complications include dehydration, electrolyte disturbances, aspiration pneumonia, failure to thrive, gastric ischaemia and perforation, and oesophageal rupture. (2,6) Frequently, the symptoms are nonspecific, as in the present case. Symptom relief when assuming an anatomical position that widens the aortomesenteric distance (e.g.…”

Section: Discussionsupporting

confidence: 50%

“…These include conditions such as anorexia nervosa, gastric bypass surgery and severe injuries. (2,3) Modulation of the angle can also be seen following surgical correction of scoliosis (4) and during periods of rapid height gain. Intrinsic predisposing factors include a congenitally high insertion of the ligament of Treitz or a low origin of the SMA.…”

Section: Discussionmentioning

confidence: 99%

“…Intrinsic predisposing factors include a congenitally high insertion of the ligament of Treitz or a low origin of the SMA. (2) Another predisposed group of patients are those who have neurological impairments such as cerebral palsy, suggesting that weakening of the dynamic abdominal or spinal muscular brace is a contributing factor. (4) Regardless of the original insult, SMAS is a self-reinforcing condition in which obstruction and poor oral intake result in further obstruction.…”

Section: Discussionmentioning

confidence: 99%

“…prone and left lateral decubitus positions) may suggest SMAS. (2,3) SMAS is difficult to diagnose due to its rarity and the presence of more common differentials such as malrotation with midgut volvulus, local obstructing mass, pancreatitis, or biliary or peptic ulcer disease. Therefore, both the referring clinician and radiologist need to maintain a high index of suspicion.…”

Section: Discussionmentioning

confidence: 99%

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Clinics in diagnostic imaging (168)

Lai

Mahmood

2016

smedj

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A 16-year-old Chinese male patient, who had a past medical history of hyperventilation complicated by carpopedal spasms, presented to the emergency department with constipation of five days' duration, colicky abdominal pain, lethargy, weakness and body aches. He was still able to pass flatus, and did not complain of vomiting, fever, chills or rigors. On examination, the abdomen was soft and non-tender. Digital rectal examination was unremarkable, as was the full blood count, except for a raised total white blood cell count of 16.6 × 10 9 /L. Renal and liver function tests and urinalysis were also unremarkable. The patient was hospitalised for further investigation of constipation. During his hospital stay, abdominal radiography was performed (Fig. 1). He subsequently desaturated acutely, and computed tomography (CT) was performed (Fig. 2)

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Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinics in diagnostic imaging (168)

Lai

Mahmood

2016

smedj

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“…Rapid weight loss has been implicated in the development of this syndrome. The typical symptoms of SMA syndrome include abdominal pain, nausea, vomiting, anorexia and postprandial fullness [1,2]. Acute portal vein thrombosis (PVT) occurring in the setting of SMA syndrome has previously been described in a pediatric patient [3].…”

Section: Letter To the Editormentioning

confidence: 99%