Radiological Case of the Month

Subacute duodenal obstruction caused by Common Celiaco-Mesenteric Trunk anomaly-A case report

“…The length and attachment of Treitz's ligament, the level at which the duodenum crosses the vertebral column, influences the angle of SMA origin [ 11 ]. The normal SMA-aorta angle of origin ranges between 20° to 70°, whereas in Wilkie's syndrome, it steeply ranges from 6° to 15° [ 12 ]. There has been no mention of the normal angle made by the common CMT with the aorta in literature.…”

Superior Mesenteric Artery Syndrome: A Classic Presentation of a Rare Entity

“…The diagnosis of SMA syndrome is based on clinical symptoms and radiologic evidence of obstruction. Imaging (abdominal X-ray, CT scans, upper GI series) can reveal decreased intra-abdominal and retroperitoneal fat, dilatation of the first and second part of the duodenum with an abrupt cutoff at the third part and decreased aortomesenteric angle and aorta-SMA distance [ 4 ]. An aortomesenteric artery angle is an angle between the aorta and the SMA.…”

Superior Mesenteric Artery Syndrome: An Infrequent Complication of Scoliosis Surgery

“…If this angle contracts for any of the aforementioned reasons, the duodenum is squeezed between the SMA, the aorta, and the vertebral column. Consequently, complete or partial obstruction can occur in the third part of the duodenum [14, 15]. Approximately 15 causes of SMAS have been identified, including the following: a narrow SMA-aorta distance or a narrow aortomesenteric vascular angle; high fixation of the duodenojejunal flexure to the ligament of Treitz; a relatively low SMA origin; excessive weight loss (or other secondary causes of mesenteric and retroperitoneal lipid tissue loss, such as burns, anorexia, or cancer); severe injuries, such as head trauma; surgical complications; abnormal peritoneal attachments associated with duodenal malrotation; excessive lumbar lordosis; visceroptosis; and a loose abdominal wall [3–5].…”

“…Doppler ultrasonography and angiography are also used to evaluate the aortomesenteric angle [9, 21, 22]. Laparoscopic diagnosis has also been reported [8, 14]. However, currently, the most efficient method for diagnosis is oral and intravenous contrast-enhanced abdominal tomography and angiography.…”