Superior mesenteric artery syndrome

Hines, James R.; Gore, Richard M.; Ballantyne, Garth H.

doi:10.1016/0002-9610(84)90339-8

Cited by 186 publications

(79 citation statements)

References 7 publications

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“…4,6,9 Surgery may be indicated when conservative treatment is not ecient: duodenojejunostomy seems to be the best procedure. 9,23,25 Cleavage of the ligament of Treitz is another option, enabling the duodenum to drop away from the apex of the sharpened aortomesenteric angle. Laparoscopic management is possible in both interventions.…”

Section: Discussionmentioning

confidence: 99%

Late superior mesenteric artery syndrome in paraplegia: case report and review

et al. 2002

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Section: Discussionmentioning

confidence: 99%

Late superior mesenteric artery syndrome in paraplegia: case report and review

et al. 2002

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“…Progression from irrelevant compression to complete obstruction is related to a number of factors that diminish the aortomesenteric angle to approximately 6–16° and the aortomesenteric distance to about 2–8 mm [5, 22, 23]. Although a thin, asthenic habitus may predispose an individual to the syndrome, an additional stimulus is probably necessary for manifestation [8].…”

Section: Anatomy and Etiologymentioning

confidence: 99%

“…Although a thin, asthenic habitus may predispose an individual to the syndrome, an additional stimulus is probably necessary for manifestation [8]. It has been observed that the superior mesenteric artery syndrome is more likely precipitated by an acute change in patient status that complicates a chronic debilitating disease [5]. Rapid weight loss and certain metabolic states lead to a depletion or loss of mesenteric and retroperitoneal fat and subsequent decrease of the aortomesenteric distance.…”

Section: Anatomy and Etiologymentioning

confidence: 99%

“…However, superior mesenteric artery syndrome might be overdiagnosed and a strict definition with precise clinical and radiographic criteria for diagnosis may substantially reduce reported prevalence rates. Hines et al [5] confirmed only 14.6% of 44 patients that had been diagnosed with superior mesenteric artery syndrome after critically reviewing the cases according to strict radiographic signs (see Diagnosis).…”

Section: Epidemiologymentioning

confidence: 99%

“…The complex of clinical signs reflecting duodenal obstruction includes postprandial epigastric pain, nausea, vomiting, anorexia and weight loss and has been termed aortomesenteric artery compression [1], arteriomesenteric duodenal compression [2], duodenal vascular compression [3], superior mesenteric artery [4,5,6], Wilkie’s [7, 8] or cast syndrome [9]. In contrast, megaduodenum characterizes a dilatation of the duodenum without primary or secondary duodenal stenosis which has been ascribed to intestinal myopathy and which can be familial [10,11,12].…”

Section: Introductionmentioning

confidence: 99%

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Recalling Superior Mesenteric Artery Syndrome

Welsch

Büchler²,

Kienle³

2007

Dig Surg

337

474

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Background: Superior mesenteric artery syndrome is uncommon and characterized by postprandial epigastric pain, nausea, vomiting, anorexia and weight loss. The syndrome is caused by compression of the third part of the duodenum in the angle between the aorta and the superior mesenteric artery. This review updates etiology, epidemiology, diagnosis, treatment and outcome of the superior mesenteric artery syndrome. Methods: Review of the literature. Results: Frequently, predisposing medical conditions associated with catabolic states or rapid weight loss result in a decrease of the aortomesenteric angle and subsequent duodenal obstruction. External cast compression, anatomic variants and surgical alteration of the anatomy following spine surgery or ileoanal pouch anastomosis can also precipitate the syndrome. Once radiologic studies have established diagnosis, first-line treatment is usually conservative with jejunal or parenteral nutrition for restoration of the aortomesenteric fatty tissue. If conservative management fails, surgical options include open or laparoscopic duodenojejunostomy or duodenal mobilization and division of the ligament of Treitz. Conclusion: Superior mesenteric artery syndrome is clearly defined and frequently associated with a wide range of predisposing conditions and surgical procedures; clinicians have to consider this syndrome in such a setting. Larger studies are needed to better define the optimal treatment for this disease.

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