Wilkie’s Syndrome in an Adolescent: A Rare Etiology of Upper Intestinal Obstruction

Roriz-Silva R,Schesquini Krp,Maranhão T

doi:10.15744/2348-9820.5.205

Roriz-Silva R, Schesquini Krp + Show 1 more

Open Access

https://doi.org/10.15744/2348-9820.5.205

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Abstract

Wilkie’s Syndrome (WS) was described in 1927 and its physiopathology is related to the formation of an abnormal acute aortomesenteric angle measuring between 7o and 22o. It leads to digestive symptoms due to external compression of mesentery artery against the third portion of duodenum.

Highlights

Wilkie’s syndrome or Superior Mesenteric Artery Syndrome is a rare condition of upper intestinal obstruction
The incidence is from 0.013 to 0.3% [1]. This disorder is characterized by extrinsic compression of the third portion of the duodenum due to an abnormal acute angle between the aorta and the superior mesenteric artery, or due to presence of an overlapping of the ligament of Treitz in the retroperitoneum [1]
The superior mesenteric artery syndrome results from the formation of an abnormal acute angle measuring between 7o and 22o and may have different causes, such as increased lumbar lordosis or use of orthotics for correcting posture [11]

Summary

Introduction

Wilkie’s syndrome or Superior Mesenteric Artery Syndrome is a rare condition of upper intestinal obstruction. The patient presented with postprandial vomiting and abdominal pain, cramps in the mesogastrium which began three months previously and were concurrent with hyporexia and weight loss over 17 kg during that period. He was admitted to the Division of General Surgery of the Hospital de Base, in the city of Porto Velho, Brazil and physical examination showed malnutrition status with emaciation - grade 3 - according to World Health Organization. Annex Publishers | www.annexpublishers.com on two plans, in the second portion of the duodenum (Figure 2A and B) He developed extensive pneumonia in postoperative period (fourth day) and ventilatory support in the intensive care unit for two weeks was required. He was followed after the surgical procedure for 2 years with complete reversion of symptoms

Discussion

Conclusion