Superior mesenteric artery syndrome: A diagnosis to be kept in mind (Case report and literature review)

Salem, Ali; Al-Ozaibi, Labib; Nassif, Suad; Osman, R.; Abed, Nisreen Mohammed Al; Badri, Faisal

doi:10.1016/j.ijscr.2017.03.018

Cited by 48 publications

(74 citation statements)

References 8 publications

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“…It is presumably a primitive form in an otherwise constitutionally lean patient. Females aged between 10 to 40 years are more commonly affected as in our report [5].…”

Section: Discussionsupporting

confidence: 57%

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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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“…It is presumably a primitive form in an otherwise constitutionally lean patient. Females aged between 10 to 40 years are more commonly affected as in our report [5].…”

Section: Discussionsupporting

confidence: 57%

“…In reality, it is necessary in every quarter [5] Our choice has gone to duodeno-jejunostomy because it is simple to perform, and provides satisfactory results in 80% -100% of cases [1] …”

Section: Discussionmentioning

confidence: 99%

Superior Mesenteric Artery Syndrome: First Chadian Observation

Ouchemi¹,

Moussa²,

Kalli³

et al. 2017

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“…A number of factors can cause SMA syndrome, including malnutrition, human immunodeficiency virus infection, anorexia nervosa, malignancy, trauma, burn, and serious weight loss. 1,5 Moreover, rare causes of the syndrome include surgical intervention that distorts the anatomy and congenital shortness of the ligament of Treitz. 6 In this case, given that the patient was a healthy adult male, it was important to consider the rapid weight loss of 20 kg from malnutrition and stress of being in the military as factors that could have contributed to the development of SMA syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…Marked weight loss, anatomical variation, and surgical intervention can decrease the aortomesenteric angle. 1 SMA syndrome and renal nutcracker syndrome are usually observed in females aged 10 to 40 years. Furthermore, both syndromes occurring concurrently is highly rare.…”

Section: Introductionmentioning

confidence: 99%

Superior Mesenteric Artery Syndrome Combined with Renal Nutcracker Syndrome in a Young Male: A Case Report

2017

Korean J Gastroenterol

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Superior mesenteric artery (SMA) syndrome is one of the rare causes of small bowel obstruction. It develops following a marked decrease in the angle between SMA and the abdominal aorta due to weight loss, anatomical anomalies, or following surgeries. Nutcracker syndrome in the left renal vein may also occur following a decrease in the aortomesenteric angle. Though SMA syndrome and renal nutcracker syndrome share the same pathogenesis, concurrent development has rarely been reported. Herein, we report a 23-year-old healthy male diagnosed with SMA syndrome and renal nutcracker syndrome due to severe weight reduction. The patient visited our outpatient clinic presenting bilious vomiting and indigested vomitus for 3 consecutive days. He had lost 20 kg during military service. We suspected SMA syndrome based on abnormal air-shadow in the stomach and small bowel on abdominal X-ray; we confirmed compression of the third portion of the duodenum with upper gastrointestinal series and abdominal computed tomography (CT). Concurrently, renal nutcracker syndrome was also detected via abdominal CT and Doppler ultrasound. Considering bilious vomiting and no urinary symptoms, SMA syndrome was corrected by laparoscopic duodenojejunostomy, and close observation for the renal nutcracker syndrome was recommended. (Korean J Gastroenterol 2017;70:253-260)

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“…POCUS of the abdomen is a good screening tool for bowel obstruction and vascular lesions. Treatment of SMA syndrome depends on the symptoms, and surgery is indicated if conservative nutritional therapy fails 3…”

Section: Answer C (Sma Syndrome)mentioning

confidence: 99%

A man with intolerant vomiting

Liang¹,

Tsai²

2019

Emerg Med J

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Case presentationA 57-year-old man was in a healthy state until 6 hours before presenting to the emergency department, when he suffered from more than 10 episodes of vomiting after a large meal at lunchtime. On physical examination, vital signs were unremarkable. Tenderness was noted over the epigastrium on palpation. Point-of-care ultrasound (POCUS) of the abdomen is shown in figure 1 and online supplementary video 1.Supplementary videoFigure 1Transverse (A) and longitudinal (B) ultrasonography of the epigastrium.QuestionWhat is the most likely diagnosis?Hypertrophic pylorus stenosisAortic dissectionSuperior mesentery artery (SMA) syndromeVolvulusFor answer see page 2

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Superior mesenteric artery syndrome: A diagnosis to be kept in mind (Case report and literature review)

Cited by 48 publications

References 8 publications

Superior Mesenteric Artery Syndrome: First Chadian Observation

Superior Mesenteric Artery Syndrome: First Chadian Observation

Superior Mesenteric Artery Syndrome Combined with Renal Nutcracker Syndrome in a Young Male: A Case Report

A man with intolerant vomiting

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