Síndrome de Wilkie: a propósito de un caso

Abstract

Wilkie syndrome is an unusual form of high gastroin- testinal obstruction resulting from compression of the duodenum between the abdominal aorta and the superior mesenteric artery (SMA). The conditions that cause this syndrome can be classified into five categories: severe wasting diseases, severe injuries, diseases, deformity or trauma to the spine, dietary disorders and posoperative state. The symptoms include nausea, vomiting, distention postprandrial, epigastric pain and weight loss. Barium meal and arteriography were used as diagnostic tools, now CT-angiography is being used and shown higher diagnostic sensitivity. The diagnostic criteria are: dilated duodenum, compression of the duodenum by the SMA and aortomesenteric angle <20 degrees. Patients with acute syndrome often respond to conservative treatment (decompression, correction of dehydration and elec- trolyte imbalance and nutrition support). Most of the patients with chronic syndrome require surgical inter- vention. Duodenojejunostomy is the most effective surgi- cal option, with a success rate of 90%. (Nutr Hosp. 2011;26:646-649) DOI:10.3305/nh.2011.26.3.5215