Superior mesenteric artery syndrome treated successfully by endoscopy-assisted jejunal feeding tube placement

Kim, Jong‐Kuk; Yang, Song-Soo; Im, Yeong Cheol; Park, Inkyu

doi:10.1136/bcr-2021-245104

Cited by 3 publications

(1 citation statement)

References 22 publications

(17 reference statements)

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“…After decompression therapy, gaining weight to increase adipose tissue between SMA and aorta should be considered. Nasal gastric feeding is effective, but the jejunal tube is more ideal while endoscopic assistant should be considered[ 136 ]. Total parenteral nutrition is a useful option for initial nutrient treatment and if the intestinal feedings are impossible.…”

Section: Treatmentsmentioning

confidence: 99%

Superior mesenteric artery syndrome: Diagnosis and management

Oka¹,

Awoniyi²,

Hasegawa³

et al. 2023

World J Clin Cases

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Superior mesenteric artery (SMA) syndrome (also known as Wilkie's syndrome, cast syndrome, or aorto-mesenteric compass syndrome) is an obstruction of the duodenum caused by extrinsic compression between the SMA and the aorta. The median age of patients is 23 years old (range 0-91 years old) and predominant in females over males with a ratio of 3:2. The symptoms are variable, consisting of postprandial abdominal pain, nausea and vomiting, early satiety, anorexia, and weight loss and can mimic anorexia nervosa or functional dyspepsia. Because recurrent vomiting leads to aspiration pneumonia or respiratory depression via metabolic alkalosis, early diagnosis is required. The useful diagnostic modalities are computed tomography as a standard tool and ultrasonography, which has advantages in safety and capability of real-time assessments of SMA mobility and duodenum passage. The initial treatment is usually conservative, including postural change, gastroduodenal decompression, and nutrient management (success rates: 70%-80%). If conservative therapy fails, surgical treatment ( i.e ., laparoscopic duodenojejunostomy) is recommended (success rates: 80%-100%).

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Section: Treatmentsmentioning

confidence: 99%

Superior mesenteric artery syndrome: Diagnosis and management

Oka¹,

Awoniyi²,

Hasegawa³

et al. 2023

World J Clin Cases

View full text Add to dashboard Cite

show abstract

New frontiers for therapeutic endoscopic ultrasound in children

Faraci

Imondi

Angelis

et al. 2023

Int J Gastrointest Interv

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Superior mesenteric artery syndrome in oncology: Report of two cases and review of the literature

Minzer,

Tenorio,

Descalzi

et al. 2024

J Case Rep Images Oncology

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A rare cause of abdominal pain is the superior mesenteric artery syndrome (SMAS), characterized by an extrinsic compression of the third portion of the duodenum by the superior mesenteric artery. It occurs in the context of rapid weight loss, because of the decrease of intra-abdominal fat causing a reduction in the exit angle of this important vascular structure. Cancer patients frequently present with weight loss, often severe, making them a population at risk of presenting this syndrome. Because symptoms are vague and could be secondary to oncologic treatments, the diagnosis of SMAS is often overlooked. We present two cases of oncology patients evaluated in the National Cancer Institute in Chile who presented with symptoms suggestive of SMAS, weight loss greater than 5 kg in a short period of time associated with abdominal pain and vomiting. Both cases were confirmed by images [computed tomography (CT) scan] and treated with nutritional support only. We present both cases along with a brief review of the literature on this rare syndrome, which is usually a diagnostic challenge.

show abstract

Superior mesenteric artery syndrome treated successfully by endoscopy-assisted jejunal feeding tube placement

Cited by 3 publications

References 22 publications

Superior mesenteric artery syndrome: Diagnosis and management

Superior mesenteric artery syndrome: Diagnosis and management

New frontiers for therapeutic endoscopic ultrasound in children

Superior mesenteric artery syndrome in oncology: Report of two cases and review of the literature

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