Superior Mesenteric Artery Syndrome: An Uncommon Cause of Feeding Intolerance in Infancy

A comprehensive review of superior mesenteric artery syndrome

“…a) Severe debilitating illnesses or chronic wasting diseases: causing prolonged best rest and asthenic built like malignancy, cerebral palsy, paraplegia, juvenile rheumatoid arthritis [1], drug abuse [6], secondary to cardiac cachexia [14], AIDS [15,16]; b) Trauma: polytrauma patients in ICU [5,10,12], extensive burn injury [1,10,12], brain and spinal cord injury [12,13,17]; c) Dietary disorders: causing severe weight loss; malabsorption syndrome [12], anorexia nervosa (psychiatric disorder) [13]; d) Postoperative states: bariatric surgery [1,7,18], esophagectomy [7], aortic aneurysm repair, and traumatic mesenteric arteriovenous fistula following abdominal aortic aneurysm repair [4,12], spinal instrumentation, scoliosis with sagittal kyphosis causing severe trunk collapse, in vertebral fractures or external compression by a body cast (hence the name 'Cast Syndrome') [7], proctocolectomy, and ileoanal pouch anastomosis [4,19], Nissen fundoplication [20]; e) Local pathology: neoplastic growth in mesenteric root, dissecting aortic aneurysm [4], traumatic aneurysm of the SMA after a stab wound [12], a flaccid abdominal wall with visceroptosis [8,12], associated with peptic ulcer disease [12], in connective tissue disorders [21], unfrequently associated with coeliac axis compression syndrome [22], compression by a huge mycotic abdominal aortic aneurysm [23]; f ) Other conditions: increased lumbar lordosis as in pregnancy [2], in hyperthyroidism [4], weight loss due to ch...…”

“…However, females are more commonly affected, in a ratio of 3:2; yet, the syndrome has also been described in a preterm male of 23 weeks 6 days; as well as in an 86-year-old man. No racial differences have been identified [1,2,5].…”

Superior mesenteric artery syndrome: a rare cause of complete intestinal obstruction in neonates

“…In neonates and infants, SMAS is extremely rare, presenting as an uncommon cause of incomplete duodenal obstruction or feeding intolerance [2,3].…”

Le syndrome de la pince aorto-mésentérique chez l’enfant : à propos d’un cas primitif

“…Plusieurs noms lui sont prêtés : syndrome de l'artère mésentérique supérieure, cast syndrome (syndrome du corset plâtré), syndrome de Wilkie, iléus duodénal chronique etc. Il s'agit d'une affection rare, parfois méconnue et très peu de cas ont été publiés chez le nourrisson [ 3 , 4 ]. Sur le plan physiopathologique, ce syndrome est lié à un espace aorto-mésentérique réduit, inférieur à 8 mm au niveau du troisième duodénum associé à un angle aorto-mésentérique inférieur à 20° [ 6 , 7 ].…”

“…Il s'agit d'une affection multifactorielle, rare chez l'enfant. Un amaigrissement important, une déformation du rachis lombaire et des anomalies anatomiques (un ligament de Treitz court, une insertion basse de l'artère mésentérique supérieure sur l'aorte) sont les facteurs favorisants les plus fréquemment retrouvés [ 3 , 4 ]. Nous rapportons un cas primitif de syndrome de la pince aorto-mésentérique observé chez un nourrisson et discutons les aspects étiopathogéniques, les moyens diagnostiques et thérapeutiques.…”