Superior Mesenteric Artery Syndrome in Identical Twin Brothers.

Abstract

Wereport two identical male twins whosuffered from superior mesenteric artery (SMA) syndrome. A 28-yearold manwas admitted for investigation of postprandial nausea and vomiting. Upper gastrointestinal examination revealed a dilated proximal duodenumwith an abrupt vertical cutoff of barium flow in the third portion of the duodenum, establishing the diagnosis of SMAsyndrome. One year later, his twin brother also presented similar symptomsand was radiologically diagnosed as SMAsyndrome. The twin brothers did not respond adequately to conservative therapy and underwent duodenojejunostomy. This is the first report of SMAsyndrome in identical twins. (Internal Medicine 40: 713-715, 2001)

Superior mesenteric artery syndrome in an infant: case report and literature review

“…Superior mesenteric artery syndrome usually occurs in young people, and its incidence has been reported as being from 0.013% to 0.3% [3,[18][19][20]. It is extremely rare for this syndrome to occur in infants or neonates; only 5 cases, including ours, have been reported [15,21,22] (Table 1).…”

Infrarenal transposition of the superior mesenteric artery: A new approach in the surgical therapy for Wilkie syndrome

“…The SMA syndrome can occur after rapid weight loss from anorexia nervosa, 5,6 trauma, 7,8 brain injury, 9 orthopedic surgery for correction of spinal deformities, 2,8 immobilization with a body cast (cast syndrome), 10 gastrointestinal surgery, compression by the median arcuate ligament of the diaphragm, extrinsic compression by an abdominal aortic aneurysm, 11,12 cardiovascular surgery (correction after aortic coarctation), and even familial cases have been reported. 13 Because Wilkie syndrome is very rare, it is usually diagnosed after ruling out other more common causes and thus can take some time. The initial treatment is usually conservative, and surgical intervention should be sought if it fails.…”

Paradigmenwechsel in der Behandlung des Wilkie-Syndroms

“…6 Monaten bestehenden Beschwerden wie abdominelles Völlegefühl bereits nach geringer Nahrungsaufnahme, postprandialen epigastrischen Schmerzen und Meteorismus vor. Sie hatte einen ungewollten Gewichtsverlust von 8 kg in 4 Monaten und berichtete über ein Hungergefühl, ohne Appetit zu haben.…”

“…Das AMS-Kompressionssyndrom kann auftreten nach rapidem Gewichtsverlust mit Reduzierung auch des retromesenterialen Fettgewebes (Anorexia nervosa; [3,14]), posttraumatisch [9,10], nach Schädel-Hirn-Verletzung [11], nach orthopädischer Rekonstruktion bei Wirbelsäulendeformität [10], Immobilisierung im Körperrumpfgips ("body cast syndrome"; [5]), nach gastrointestinaler Chirurgie, durch Einengung des Ligamentum arcuatum, durch äußere Kompression durch ein Aortenaneurysma [1,15] oder nach aortaler Rekonstruktion wegen Coarctatio aortae abdominalis. Des Weiteren wurde auch eine familiäre Disposition beschrieben [6].…”