1390: Correlation of Aortomesenteric Angle and Malnourished Status with SMA Syndrome in Suspicious Malnourished Pediatric Patients

Abstract

To correlate aortomesenteric angle (AA) and malnourished status with superior mesenteric artery syndrome (SMAS) in clinically suspicious malnourished patients. We conducted a 5-year ultrasound evaluation of AA to detect SMAS in clinically suspicious malnourished children (weight-for-height index <80 %), aged 6-18 years. All the subjects were assigned upper gastrointestinal (UGI) barium studies for confirmation of SMAS. The AA of 200 age-matched healthy children was used as control. AA was statistically correlated with nutritional status and SMAS. A total of 103 studied subjects (43 males, 60 females; mean age: 11.81 ± 3.31 yr) were enrolled. Mean weight-for-height index, BMI-for-age z score and AA of studied and control groups were 76.13 ± 2.76 %, -2.17 ± 0.26, and 17.18 ± 2.63°, and 96.79 ± 10.32 %, -0.11 ± 0.97, and 28.74 ± 5.58°, respectively. Thirty-two subjects met the diagnostic criteria on UGI studies. The malnourished status between SMAS and non-SMAS subjects showed no significant difference, while a significant difference of mean AA was found between SMAS (13.94 ± 2.93, range: 8.1-17.7) and non-SMAS subjects (18.64 ± 2.62range, 12.4-24.8) (p < 0.001). AA< 16° correlated with the presence of SMAS (p = 0.011). The malnourished status and AA were similar between 6-12 yr and 12-18 yr group patients, AA< 15° correlated with SMAS in both age groups (p = 0.044, 0.028). The malnourished status can not detect SMAS in suspicious malnourished pediatric patients, while cutoff AA < 15° helps to detect the presence of SMAS.