Superior Mesenteric artery syndrome

Abstract

Superior mesenteric artery syndrome (SAMS) or Wilkie syndrome is a rare clinical condition, the incidence of superior mesenteric syndrome reported in some previous studies can range from 0.013% to 0.78% but the true incidence is unknown. This syndrome is characterized by extrinsic constriction on the anterior surface of the duodenum by the superior mesenteric artery and the abdominal aorta, leading to the formation of an aortomesenteric angle < 25°, and a decrease in the normal distance between the aorta and the mesenteric artery to 2-8 mm. Objective: Therefore, the objective of the present study is to carry out a systematic review of the literature to describe the superior mesenteric artery syndrome. Methodology: This study is a systematic literature review, with a qualitative approach, with interpretation and analysis of the elements obtained. The research was carried out from the survey of scientific articles found in the main search platforms for scientific articles: ScienceDirect, PubMed, SciELO, Bireme, from 2017 to 2022. Results and discussion: For this review 15 articles were selected as the studies showed that the symptoms of Wilkie syndrome are confusing, epigastric pain, vomiting, heartburn may be signs of other gastrointestinal pathologies such as gastroesophageal reflux, as presented in the literature. In chronic patients, non-operative therapy is often prolonged due to the long period of hospitalization, with a low success rate ranging from 14 to 71%. Strong's operation, gastrojejunostomy, and duodenujejunostomy are treatment options for Wilkie syndrome. Final considerations: The diagnosis of Wilkie syndrome often depends on a high index of clinical exclusion of other diseases, resulting in ineffective symptomatic symptoms. For this reason, a detailed history should be taken and after careful endoscopic evaluation, CT images should be analyzed carefully and surgery should be considered in cases of longer duration with nutritional support, always emphasizing the importance of individual assessment of each patient.