Arteriomesenteric duodenal compression

Abstract

1. 1. Fourteen surgically treated patients with arteriomesenteric duodenal compression are presented. Twelve have been relieved of digestive symptoms, and two are improved. 2. 2. A high index of suspicion is advocated in evaluating patients with vague abdominal complaints of long-standing. 3. 3. Methods of diagnosing this condition at the operating table are discussed. In four cases, five abdominal operations by other surgeons had failed to demonstrate the condition. Air insufflation has been of value in our hands in recognizing this syndrome. 4. 4. Diagnosis by roentgenogram is not certain. The condition may be overlooked or diagnosed too frequently. 5. 5. This syndrome should be considered when surgery for peptic ulcers is indicated. The presence of arteriomesenteric duodenal compression will alter the surgical procedure used in the treatment of patients with ulcers. Patients who have had a poor response to surgery for ulcers should be re-evaluated with this condition in mind. 6. 6. This clinical entity should be treated surgically if medical treatment fails. Conservatism in both diagnosis and treatment must be stressed. 7. 7. The accuracy of the conclusions drawn in this preliminary paper must be determined by further studies.