A Model Example: Coexisting Superior Mesenteric Artery Syndrome and the Nutcracker Phenomenon

Abstract

Aorto-mesenteric clamp syndrome or Wilkie's syndrome is a rare cause of upper intestinal obstruction resulting from compression of the third portion of the duodenum as it passes between the superior mesenteric artery and the aorta. Clinically, it is characterized by intermittent vomiting, nausea and abdominal pain related to the degree of duodenal compression. The diagnosis is based on abdominal computed tomography. Medical management with decompression using a nasogastric tube and adequate nutritional support are initially recommended. Surgical treatment is indicated in case of failure of conservative management.