Favorable minimal invasive surgery in the treatment of superior mesenteric artery syndrome: Case report

Barchi, Leandro Cardoso; Alves, Aline Marcilio; Jacob, Carlos Eduardo; Bresciani, Cláudio José Caldas; Yagi, Osmar Kenji; Nogueira, Tarsila Gasparotto; Cecconello, Ivan; Zilberstein, Bruno

doi:10.1016/j.ijscr.2016.09.016

Cited by 14 publications

(27 citation statements)

References 11 publications

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“…Wilkie described the pathophysiology and treatment from a series of 64 patients in 1927. This syndrome received many designations over the years: mesenteric forceps syndrome, Wilkie's syndrome, duodenal arterio-mesenteric compression syndrome [1] [2] [3]. The syndrome is related to a reduced aorto-mesenteric space, less than 8 mm in the third duodenum associated with aortic mesenteric angle less than 22˚.…”

Section: Discussionmentioning

confidence: 99%

“…The syndrome is related to a reduced aorto-mesenteric space, less than 8 mm in the third duodenum associated with aortic mesenteric angle less than 22˚. Normally, the thickness of the adipose tissue surrounding the superior mesenteric artery (SMA) at its origin allows this angle to be maintained and protects the duodenum from vascular compression [3] [4]. Some favorable factors have been described, including: rapid weight loss leading to melting of mesenteric fat or spinal deformity (hyperlordosis, trauma).…”

Section: Discussionmentioning

confidence: 99%

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Superior Mesenteric Artery Syndrome: First Chadian Observation

Ouchemi¹,

Moussa²,

Kalli³

et al. 2017

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Introduction: The extrinsic compression of the third portion of the duodenum between the superior mesenteric artery and the aorta defines superior mesenteric artery syndrome. It determines an acute or chronic high intestinal obstruction pattern. We report the first observed case in Chad. Observation: HH was a 19 year-old woman with abdominal pain and intermittent postprandial vomiting since she was 5 years old. During last 11 months, postprandial vomiting was more frequent, and non resolved after medical treatment. Unquantified weight loss was reported. Body mass index at hospitalization was 9.8. An injected abdominal scan demonstrated significant gastroduodenal distension, upstream of a stenosis of the third duodenal portion. Aorto-mesenteric space and angle were reduced. At laparotomy internal derivation by duodenojejunostomy was done. Postoperative situation was uneventful. Conclusion: Superior mesenteric artery syndrome determines an acute or chronic intestinal obstruction. Injected abdominal scan is fundamental for diagnosis. The treatment is firstly conservative but the need of surgery is common.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Superior Mesenteric Artery Syndrome: First Chadian Observation

Ouchemi¹,

Moussa²,

Kalli³

et al. 2017

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“…The main symptoms of this condition are postprandial abdominal pain, early satiety, vomits, weight loss and malnutrition [ 3 – 5 ]. Diagnosis of SMAS is challenging but may be suspected based on clinical presentation and then supported by imaging studies [ 1 , 3 , 6 ]. SMAS may be treated medically and/or surgically [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Wilkie’s syndrome: a case report of favourable minimally invasive surgery

Santos

Loureiro

Simão

et al. 2018

Journal of Surgical Case Reports

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Wilkie’s syndrome, or superior mesenteric artery syndrome (SMAS), is a rare clinical entity caused by compression of the third portion of the duodenum between the abdominal aorta and superior mesenteric artery, leading to duodenal obstruction and severe malnutrition. The authors report a case of a female patient with years of chronic intestinal obstruction with abdominal pain, vomits and weight loss. Contrast intestinal series showed dilation of stomach and duodenum. Abdominal computed tomography study revealed findings compatible with SMAS. After initial nutritional support, she was successfully treated by laparoscopic duodenojejunostomy. Surgical treatment of SMAS may be necessary in most cases with chronic symptoms or conservative treatment failure. A minimally invasive approach can be considered a safe surgical option with favourable outcomes. Clinical details, diagnostic studies and treatment are discussed.

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“…Superior Mesenteric Artery Syndrome (SMAS), or Wilkie's Syndrome, is a rare medical condition, which includes symptoms and clinical manifestations of duodenal obstruction, such as postprandial epigastric pain, nausea, vomiting, anorexia and weight loss . The above manifestations result from extrinsic compression of the third portion of the duodenum, between a narrow aortomesenteric angle . The diagnosis can be established with an upper gastrointestinal X‐ray series, computed tomography and angiography, magnetic resonance (MR) angiography, ultrasonography, endoscopy and more rarely conventional angiography …”

Section: Introductionmentioning

confidence: 99%

“…1,2 The above manifestations result from extrinsic compression of the third portion of the duodenum, between a narrow aortomesenteric angle. 2,3 The diagnosis can be established with an upper gastrointestinal X-ray series, computed tomography and angiography, magnetic resonance (MR) angiography, ultrasonography, endoscopy and more rarely conventional angiography. 2 The initial approach is conservative, with stomach decompression and nutritional support.…”

Section: Introductionmentioning

confidence: 99%