Superior Mesenteric Artery Syndrome Research Articles

Superior Mesenteric Artery Syndrome in Patients with Snake Bites

Superior Mesenteric Artery Syndrome in Patients with Snake Bites

Duodenal compressions from non-SMA structures in the same patient causing SMA-like syndrome: a rare case report

Abstract SMA-like syndrome is an increasingly used term to describe vascular compression of the third duodenal portion between structures other than superior mesenteric artery and aorta. Although rare, this clinical condition is as serious as true SMA syndrome and requires similar management. However, the diagnostic criteria are not well-established yet and require a case-by-case analysis, including a review of various clinical symptoms, especially evolving ones, as well as radiological imaging and effectiveness of conservative therapeutic maneuvers. The presented case involves a double vascular compression, in a 50-year-old woman with no medical history, one of which is between two venous structures. The patient had been experiencing recurrent abdominal pain, vomiting and distension for a long time. Laboratory tests were normal, and gastroesophageal endoscopy revealed Barrett’s esophagus. CT- enterography revealed two duodenal vascular compressions. Dietary measures were initiated with close follow-up. To the best of our knowledge, this is the first reported case in the world literature and adds to the existing body of SMA-like syndromes.

Association of Superior Mesenteric Artery Syndrome and Lumbar Scoliosis

Association of Superior Mesenteric Artery Syndrome and Lumbar Scoliosis

S3901 A Rare Case of Median Arcuate Ligament Syndrome Leading to Superior Mesenteric Artery Syndrome

S3901 A Rare Case of Median Arcuate Ligament Syndrome Leading to Superior Mesenteric Artery Syndrome

S2680 Acute Recurrent Pancreatitis Secondary to Superior Mesenteric Artery Syndrome

S2680 Acute Recurrent Pancreatitis Secondary to Superior Mesenteric Artery Syndrome

S4795 A Case of Partial Duodenal Obstruction Secondary to Superior Mesenteric Artery Syndrome

S4795 A Case of Partial Duodenal Obstruction Secondary to Superior Mesenteric Artery Syndrome

Assessment of aortomesenteric distance and mesenteric and retroperitoneal adipose tissue thickness in genetic forms of lipodystrophy.

Lipodystrophy is a rare disease characterized by the loss of adipose tissue. Visceral adipose tissue loss in certain forms of lipodystrophy may affect the amount of mesenteric fat. We studied visceral adipose tissue by measuring the thickness of mesenteric and retroperitoneal adipose tissue and the aortomesenteric (AOM) distance in patients with genetic forms of lipodystrophy (n = 48; 7 males; 41 females; mean age 39.1 ± 11.9 years; 19 with congenital generalized lipodystrophy [CGL], and 29 with familial partial lipodystrophy [FPLD]). An age- and gender-matched control group with a ratio of 1:2 was generated. Patients with CGL had severely depleted mesenteric adipose tissue (2.0 [IQR: 1.5-3.5] mm vs. 18.8 [IQR: 4.4-42.2] mm in FPLD, P < .001; 30.3 [IQR: 13.9-46.6] mm in controls, P < .001) and retroperitoneal adipose tissue (1.3 [IQR: 0.0-5.3] mm vs. 33.7 [IQR: 21.6-42.1] mm in FPLD, P < .001; 29.7 [IQR: 23.1-36.7] mm in controls, P < .001). The AOM distance was shorter in patients with CGL (8.1 [IQR: 6.0-10.8] mm) compared to patients with FPLD (vs. 13.0 [IQR: 8.8-18.1] mm; P = .023) and controls (vs. 11.3 [IQR: 8.4-15.5] mm, P = .016). Leptin levels were positively correlated with AOM distance in lipodystrophy (r = .513, P < .001). Multivariate linear regression analysis identified body mass index as a significant predictor of AOM distance (data controlled for age and sex; beta = 0.537, 95% CI: 0.277-0.798, P < .001). Twelve of 19 patients (63%) with CGL had an AOM distance of < 10mm, a risk factor that may predispose patients to developing superior mesenteric artery syndrome. CGL is associated with a severe loss of mesenteric adipose tissue, which leads to a narrowing of the space between the superior mesenteric artery and the aorta.

S4869 A Delayed Presentation of Superior Mesenteric Artery Syndrome Treated With Robotic-Assisted Strong Procedure

S4869 A Delayed Presentation of Superior Mesenteric Artery Syndrome Treated With Robotic-Assisted Strong Procedure

Unusual neonatal case of superior mesenteric artery syndrome with MeckelÓ?s diverticulum and literature review

Unusual neonatal case of superior mesenteric artery syndrome with MeckelÓ?s diverticulum and literature review

Laparoscopic Surgery for Superior Mesenteric Artery Syndrome.

Superior mesenteric artery syndrome (SMAS) is a rare condition, for which laparoscopic surgery was successfully performed safely and with long-term efficacy. This single center retrospective clinical study comprised 66 patients with SMAS, surgically treated between January 2010 and January 2020, who were allocated to three different surgical groups according to their medical history and symptoms (Laparoscopic duodenojejunostomy, n = 35; Gastrojejunostomy, n = 16; Duodenojejunostomy plus gastrojejunostomy, n = 15). Patient demographics, surgical data and postoperative outcomes were retrieved from the medical records. All operations were successfully completed laparoscopically, and with a median follow-up of 65 months, the overall symptom score was significantly reduced from 32 to 8 (p < 0.0001) and the BMI was increased from 17.2 kg/m2 to 21.8 kg/m2 (p < 0.0001). When conservative measures failed in the treatment of SMAS, laparoscopic surgery proved to be a safe and effective method. The specific surgical technique was selected according to the history and symptoms of each individual patient. To our knowledge, this study represents the largest number of laparoscopic procedures at a single center for the treatment of superior mesenteric artery syndrome.

Superior mesenteric artery syndrome managed laparoscopically: a case report

BackgroundSuperior mesenteric artery syndrome is a rare condition that has only around 400 reported cases so far. Typically, the superior mesenteric artery branches off the abdominal aorta at 45° to create an aortomesenteric distance of 10–28 mm, with the duodenum passing through. However, if this aortomesenteric angle reduces to less than 25°, the third portion of the duodenum becomes compressed between the SMA and aorta, causing mechanical obstruction.Case presentationThis case report aims to demonstrate the diagnostic difficulties and the laparoscopic management of a 52-year-old Indian male presenting with abdominal pain and vomiting, with associated weight loss. Imaging was further suggestive of high intestinal obstruction, and he was later found to have superior mesenteric artery syndrome.ConclusionTaking into account a significant reduction in morbidity, we propose laparoscopic duodenojejunostomy to be the new procedure of choice for superior mesenteric artery syndrome.

Superior mesenteric artery syndrome following spine surgery in idiopathic adolescent scoliosis: a systematic review

Superior mesenteric artery syndrome (SMAS) is a rare and unpredictable complication after correction spine surgery for adolescent idiopathic scoliosis (AIS). The management of this condition is poorly investigated, with controversial outcomes. This investigation systematically reviewed current evidence on pathogenesis, risk factors, management, and outcomes of SMAS following correction spine surgery for AIS. The present systematic review was conducted according to the 2020 PRISMA statement. All the included investigations reported SMAS presentation following scoliosis correction surgery in AIS. 29 articles with 61 eligible patients were included in this review. The mean age of the patients was 15.8 ± 7.2 years. The mean weight was 45.3 ± 8.0 kg, the mean height 159.6 ± 13.6 cm, and the mean BMI 16.5 ± 2.9 kg/m2. The mean duration of the treatment for SMAS was 21.6 ± 10.3 days. The mean interval between spine surgery and symptoms of SAMS was 69 days, with high between-studies variability (3 days to 4 years). Prompt identification of risk factors and an early diagnosis are necessary to manage SMAS and reduce the risk of complications. Additional investigations are required to establish risk factors and diagnostic criteria.Level of evidence Level IV, systematic review.

Superior Mesenteric Artery Syndrome (Wilkie?s Syndrome): Acute Severe Presentation in a 12 - Year - Old Girl and Role of Early Diagnosis

Superior Mesenteric Artery Syndrome (Wilkie?s Syndrome): Acute Severe Presentation in a 12 - Year - Old Girl and Role of Early Diagnosis

Gastric perforation as a complication of Wilkie's syndrome.

Wilkie's syndrome, also known as Superior mesenteric artery (SMA) syndrome, is characterized by intestinal obstruction due to aortomesenteric duodenal compression caused by the reduction of the normal angle between (38-65º) to <25º or to a distance <8mm. The clinical presentation is usually non-specific (dyspepsia, postprandial abdominal pain) but sometimes presented as an acute intestinal obstruction syndrome (nausea, vomiting, gastric dilatation and abdominal distention). In this study, we report the case of a 22-year-old patient with a BMI of 16.5 who presented to the emergency room with acute intestinal obstruction caused by SAMS. He presented with massive gastric dilation that caused ischaemic necrosis of the gastric mucosa with subsequent perforation. It should be noted that only one case associated with Wilkie syndrome has been described in the literature. Therefore, given the rare incidence of complications associated with this syndrome and the favourable prognosis with conservative management, surgery is usually the last line of treatment. However, we must not forget that when necrosis appears, it is often extensive and requires urgent surgical treatment in most cases.

Association between underweight status or low body mass index and the risk of developing superior mesenteric artery syndrome following scoliosis corrective surgery in pediatric patients: a review of the literature

Superior mesenteric artery (SMA) syndrome is the compression of the third portion of the duodenum between the abdominal aorta and the superior mesenteric artery. Although multifactorial, the most frequent cause of SMA syndrome is significant weight loss and cachexia often induced by catabolic stress. SMA syndrome resulting from scoliosis surgery is caused by a reduction of the aortomesenteric angle and distance. Risk factors include rapid weight loss, malnutrition, and a rapid reduction in the mesenteric fat pad and are the most common causes of a decrease in the aortomesenteric angle and distance. Surgically lengthening the vertebral column can also lead to a reduction of the aortomesenteric distance, therefore, has been identified as a risk factor unique to spinal surgery. Despite a reported decline in SMA syndrome cases due to improved surgical techniques, duodenal compression is still a risk and remains a life-threatening complication of scoliosis surgery. This article is a cumulative review of the evidence of being underweight or having a low body mass index as risk factors for developing SMA syndrome following surgical scoliosis instrumentation and correction.

Diagnostics and surgical management children with superior mesenteric artery syndrome

BACKGROUND: Superior mesenteric artery syndrome causes chronic duodenal obstruction. Studies on this disease are limited; therefore, several difficulties in the diagnosis and treatment of such patients remain. AIM: This study aimed to present the experience of treating children with superior mesenteric artery syndrome. MATERIALS AND METHODS: The treatment results of 45 patients with superior mesenteric artery syndrome was retrospectively studied. The children complained of abdominal pain, nausea, occasional vomiting, belching, bloating, and constipation. The diagnosis was confirmed during a comprehensive examination, including ultrasound, esophagogastroduodenoscopy, X-ray contrast examination, computed tomography, and relaxation duodenography. Conservative therapy was performed in 38 (84,4%) children, and 21 (55,3%) children showed satisfactory results. In case of ineffectiveness of conservative measures (17 cases) or in a decompensated state (7 cases), indications for surgical treatment were provided. Furthermore, 24 (53,3%) children underwent surgery. Duodenal drainage surgeries were performed in 20 (83,3%) patients with subcompensation of duodenostasis. Of these patients, 10 (41,7%) underwent lower duodenojejunostomy with a switched-off Roux-en-Y loop (Gregory–Smirnov’s operation) and the other 10 (41,7%) underwent anterior mesenteric duodenojejunostomy (Robinson’s operation). Laparotomic access was used in 14 cases (70,0%) and laparoscopic in 6 (30,0%) cases. Owing to decompensation of duodenostasis, the duodenum was excluded from passage by economical resection of the gastric outlet with gastrojejunostomy on a short loop with additional formation of a lower duodenojejunostomy according to Roux in 4 (16,7%) cases. Laparotomic access was used in all cases. RESULTS: No intraoperative complications were noted. In the early postoperative period, two children developed anastomositis after Robinson’s operation and two patients after Gregory–Smirnov’s operation, which was treated with conservative measures. In long-term followup (up to 15 years), a satisfactory result was achieved in 87.5% of cases. CONCLUSIONS: Superior mesenteric artery syndrome is a relatively rare cause of chronic duodenal obstruction in children. When selecting patients for surgical treatment, other diseases should be excluded. Surgical correction includes various options for duodenal drainage operations that can be successfully performed using laparoscopic access. In case of decompensation of duodenostasis, it may be crucial to exclude the duodenum from the passage.

Cannabinoid hyperemesis syndrome co-occurring with superior mesenteric artery syndrome in adolescents.

Both superior mesenteric artery syndrome (SMAS) and cannabinoid hyperemesis syndrome (CHS) may present with abdominal pain, nausea, and emesis - making them difficult to differentiate or determine when they co-occur in adolescents who regularly use cannabis. Here, we present nine cases of CHS co-occurring with SMAS and characterize their clinical courses. Patients admitted at Children's Hospital of Colorado between January 1, 2015, and March 23, 2023, who had both cannabis use (F12.1-F12.99) and chronic vascular disorders of the intestine (K55.1) on their problem lists were identified from the electronic medical recordusing ICD 10 codes. Nine met criteria for SMAS and chronic cannabis use. Six of nine patients were female. The most common presenting symptoms were nausea (9), vomiting (9), and weight loss (9). Four patients received cannabis cessation support. Patients lost a mean of 6.0 kg, had an average body mass index (BMI) of 15.61percentile(17.7 kg/m2) and BMI Z-scores of -1.5. Symptoms were present for a mean of 19.6 weeks before diagnosis. Adolescents who experience nausea, vomiting, abdominal pain, and weight loss in association with chronic cannabis use and/or SMAS can present with confusing and overlapping symptoms. Our cohort was described as having CHS with co-occurring SMAS on imaging. Although the etiology of weight loss cannot be definitively ascertained, we postulate that the recurring emetic attacks from CHS led to weight loss resulting in SMAS. Improvement in diagnostic criteria for this population as well as cannabis cessation programming may aid in deceasing morbidity from these co-occurring conditions.

Unusual neonatal case of superior mesenteric artery syndrome with Meckel's diverticulum and literature review.

Superior mesenteric artery syndrome (SMAS) is a rare cause of duodenal obstruction which is characterized by compression of the duodenum due to narrowing of the space between the superior mesenteric artery and aorta. Incomplete duodenal obstruction due to SMAS in neonates is rarely reported in the literature. In this case, it is a full-term 2-day-old male with the complaint of recurrent vomiting starting soon after birth. The patient was diagnosed with SMAS and duodenoduodenostomy was performed. Accompanying Meckel's diverticulum was excised.

Superior Mesenteric Artery Syndrome: A Case of SMA Syndrome

&lt;p&gt;在噁心嘔吐、食慾不振的病人中，有一群因症狀不具特異性、不易診斷而可能造成延誤治療者，是上腸繫膜動脈症候群(superior mesenteric artery syndrome)病人。因十二指腸第三部分受到上腸繫膜動脈和腹主動脈壓迫造成十二指腸阻塞症狀。此症候群盛行率低，診斷不易，易發生在體重快速減輕的病人上。這篇個案報告將介紹這個少見的症候群的臨床症狀、診斷標準、治療與預後。當面對噁心嘔吐、食慾不振的病人時，上腸繫膜動脈症候群是個不可忽略的鑑別診斷。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;Among the patients experiencing the symptoms of nausea and poor appetite, some will finally be diagnosed with superior mesenteric artery (SMA) syndrome, an unusual syndrome with various symptoms deriving from proximal intestinal obstruction caused by the compression of the third portion of duodenum due to the narrowing space between superior mesenteric artery and abdominal aorta. SMA syndrome has a low prevalence around 0.1-0.3%, occurring mostly in patients with significant weight loss and leading to mesenteric fat pad loss. In this case report, a 46-year-old woman with significant body weight loss was diagnosed with SMA syndrome. When examining patients reporting unintentional weight loss and symptoms of nausea and poor appetite, SMA syndrome should be taken into consideration as a rare but important differential diagnosis.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Understanding Superior Mesenteric Artery Syndrome: Etiology, Symptoms, Diagnosis, and Management.

Superior mesenteric artery (SMA) syndrome, also known as Wilkie's syndrome, poses a diagnostic challenge due to its rarity and varied clinical manifestations. This review explores the syndrome's etiology, symptoms, diagnostic challenges, and management strategies. Symptoms range from early satiety to severe abdominal pain, often leading to malnutrition. Diagnosis involves a thorough gastrointestinal evaluation and various imaging modalities. Management includes medical interventions like nasogastric decompression and nutritional support, along with surgical interventions such as duodenojejunostomy. A thorough understanding of SMA syndrome's complexities is crucial for its timely diagnosis and effective management, especially considering its potential overlap with other gastrointestinal disorders or eating disorders. Further research is needed to enhance understanding and improve patient outcomes.