Superior Mesenteric Artery Syndrome

A comprehensive review of superior mesenteric artery syndrome

“…aneurysm or neoplasm, etc. The advantage of CT over ultrasonography (USG) is that, it can provide an overall assessment of the abdominal cavity as well as the amount of intra-abdominal and retroperitoneal fat [1,14,19,22,28,33].…”

Wilkie's syndrome: A rare cause of vomiting and weight loss

“…Important aetiologic factors that may precipitate narrowing of the aortomesenteric angle and recurrent mechanical obstruction include, thin body build, exaggerated lumbar lordosis, visceroptosis and abdominal wall laxity, depletion of the mesenteric fat caused by rapid severe weight loss due to catabolic states such as cancer, surgery, burns, or psychiatric problems. Severe injuries, such as head trauma, spinal disease, deformity, or trauma leading to prolonged bedrest, dietary disorders such as anorexia nervosa and malabsorption may cause loss of fat [4,6]. Our patient was having symptoms of anorexia nervosa and was treated for it and later on due to severe weight loss she developed SMA syndrome.…”

“…More females are affected by SMA syndrome. The SMA usually forms an angle of approximately 45° (range 38-56°) with the abdominal aorta, and the third part of the duodenum crosses posterinferiorly to the origin of the SMA, coursing between the SMA and aorta [1,4,5]. Any factor that sharply narrows the aortomesenteric angle to approximately 6-25° can cause entrapment and compression of the third part of the duodenum as it passes between the SMA and aorta, resulting in SMA syndrome.…”

“…Confirmation usually requires radiographic studies, such as an upper gastrointestinal endoscopy, hypotonic duodenography, and CT scan. Contrast-enhanced CT scan and magnetic resonance angiography (MRA) is useful in the diagnosis of SMA syndrome and can provide diagnostic information, including aorta-SMA distances and duodenal distension [4]. Also, it can be used to assess intra-abdominal and retroperitoneal fat.…”

“…Superior mesenteric artery syndrome was first described in 1861 by von Rokitansky, who proposed that its cause was obstruction of the third part of the duodenum as a result of arteriomesenteric compression [4]. Later, Wilkie provided a more detailed clinical and pathophysiologic description in a series of 64 patients and suggested treatment approaches.…”