It has been referred to by a variety of other names, including cast syndrome, wilkie syndrome, arteriomesenteric duodenal obstruction, and chronic duodenal ileus. Radiological modalities play a major role in its diagnosis and surgical methods remain the gold standard in its management. Superior mesenteric artery syndrome smas is a rare condition caused by partial obstruction of the third portion of the duodenum by the sma anteriorly and aorta posteriorly. Superior mesenteric artery syndrome is a rare condition, causing intestinal obstruction. Navy seal jocko willink breaks down combat scenes from movies. Diagnostic techniques done for smas can be very hard and tricky. Superior mesenteric artery syndrome is a very uncommon disorder in which acute angulation of. Superior mesenteric artery syndrome rani sophia and waseem ahmad bashir yeovil hospital nhs foundation trust, yeovil, somerset united kingdom 1. This is most frequently seen after sudden and significant weight loss, but other etiologies can also cause this duodenal compression. Please share the word and ask your friends to shop through our link.
Mesenteric artery disease also known as chronic mesenteric insufficiency is the hardening of the arteries in the blood vessels that supply the bodys intestines, which is the same process that occurs with arterial blockages elsewhere. Located under this portion of the superior mesenteric artery, between it and the aorta, are the following. Typical ct and fluoroscopic appearance of superior mesenteric artery syndrome, which occurs when there is extrinsic compression of the third portion of the duodenum due to a narrowed aortomesenteric angle. Superior mesenteric artery syndrome is one of the rarest gastrointestinal disorders known to medical science. This compression causes partial or complete blockage of the duodenum. Superior mesenteric artery syndrome jama jama network. Three new cases form the basis of the present paper. It is a rare disease in which the superior mesentery artery blocks the duodenum as it crosses over it. The syndrome is characterized by compression of the third portion of the duodenum due to narrowing of the space.
Symptoms soulmates are people with similar symptoms to you. Successful nutritional therapy for superior mesenteric artery syndrome. Mesenteric artery syndrome, superior symptoms, causes, diagnosis, and treatment information for mesenteric artery syndrome, superior superior mesenteric artery syndrome with alternative diagnoses, fulltext book chapters, misdiagnosis, research treatments, prevention, and prognosis. Mesenteric artery disease peripheral arterial disease. See more ideas about superior mesenteric artery syndrome. Superior mesenteric artery syndrome as a postoperative. All but three of these segmental arteries regress as development proceeds. This results in chronic, intermittent, or acute complete or partial duodenal obstruction. Superior mesenteric artery syndrome smas was diagnosed in a 16yearold boy who presented with a short history of repeated vomiting associated with weight loss to the point of collapse. The mesenteric vessels arise from the primitive ventral segmental arteries. Historydefinition of superior mesenteric artery syndrome.
Superior mesenteric artery syndrome smas mostly occurs i n adolescent or young adults and is a rare disorder. Despite the name of the syndrome, it is not a vascular disease. Superior mesenteric artery dissection after lumbar. Superior mesenteric artery syndrome demonstrated by computed. Superior mesenteric artery syndrome consists of acute gastric dilatation and vomiting. Full text full text is available as a scanned copy of the original print version. Superior mesenteric artery syndrome as a postoperative complication following splenectomy. Superior mesenteric artery sma syndrome is an uncommon and potentially fatal cause of small bowel obstruction where the third portion of the duodenum is compressed between the abdominal aorta and the superior mesenteric artery. Only relatively recently has it established itself as a disease entity. Mesenteric artery ischemia is a condition that restricts blood flow to your intestines.
Superior mesenteric artery sma syndrome known as wilkies syndrome is a rare cause of upper gastrointestinal. First described by rokitansky in 1861, superior mesenteric artery sma syndrome, also termed cast syndrome or wilkies syndrome,1 is a rare condition where. Acute ischemia can also occur due to acute thrombotic obstruction, often in the setting of an already diseased mesenteric vessel eg, atherosclerosis. The best treatment for superior mesenteric artery syndrome is the ladds procedure posted mar 14, 2020 by macy mae 2550 superior mesenteric artery syndrome treatments. Superior mesenteric artery sma syndrome was first described by professor rokitansky in 1842 1, 2. The syndrome is characterized by compression of the third portion of the duodenum due to narrowing of the space between the. An 11yearold girl presented with acute symptoms of upper gastrointestinal obstruction with no antecedent cause. Superior mesenteric artery syndrome causes, symptoms, diagnosis, treatment, pathology duration. Ischemia due to acute mesenteric arterial occlusion can be caused by embolic obstruction of the intestinal blood supply, most commonly to the superior mesenteric artery sma. Cleveland clinic minimally invasive duodenojejunostomy for superior mesenteric artery syndromedownload clinical and radiological considerations for idiopathic smasdownload smas a prospective study in a single institution italy 2018download clinical insights into smas with. Laparoscopic duodenojejunostomy has been described as a safe and feasible surgical intervention with favorable. Abdominal discomfort, pain, and vomiting of bilestained material constituted the majority of. The outer layer anchors the organs to the abdominal cavity. Superior mesenteric artery sma syndrome is a gastrovascular disorder in which the third and final portion of the duodenum is compressed between the abdominal aorta aa and the overlying superior mesenteric artery.
Ultrasound of the abdomen showed gross hemoperitoneum and splenic injury. In the past, this syndrome was most often recognized in those treated with a hip spica or body cast, hence, the older name cast syndrome. Pdf superior mesenteric artery syndrome case report. The superior mesenteric artery sma originates behind the neck of the pancreas a t the level of the first lumbar vertebra and leaves the aorta at an acute angle. If you have problems viewing pdf files, download the latest version of adobe reader. Superior mesenteric artery sma syndrome is caused by extrinsic compression of the duodenum, which is trapped between the sma anteriorly and the aorta posteriorly as the sma crosses over the duodenum in the root of the mesentery. The superior mesenteric artery sma is a large blood vessel that supplies oxygen and nutrients to the lower digestive tract of the human abdomen. Superior mesenteric artery syndrome is uncommon and characterized by postprandial epigastric pain, nausea, vomiting, anorexia. Superior mesenteric artery syndrome semantic scholar. Rare cause of upper bowel obstruction arising in a 17. Superior mesenteric artery syndrome symptoms, diagnosis. Pdf superior mesenteric artery sma syndrome is an unusual cause of vomiting and weight loss resulting from the compression of the third part of the. The term mesentery refers to a doublelayered membrane called the peritonium, which encases the small and large intestines. Superior mesenteric artery syndrome is a rare, potentially lifethreatening gastrovascular disorder characterized by a intermittent compression and obstruction of the third and final portion of the duodenum by the abdominal aorta and the overlying superior mesenteric artery.
Introduction superior mesenteric artery syndrome smas mostly occurs i n adolescent or young adults and is a rare disorder. After resuscitation and investigation, he was treated surgically and subsequently recovered well. Acute vascular compression of the duodenum is a rare cause of duodenal obstruction in children. Superior mesenteric artery syndrome symptoms, treatments. Only 12 cases of superior mesenteric artery syndrome in the young have been reported in the literature available to the authors. Superior mesenteric artery syndrome genetic and rare diseases. Case report superior mesenteric artery syndrome and its rami. More detailed information about the symptoms, causes, and treatments of superior mesenteric artery syndrome is available below. Superior mesenteric artery syndrome causes, symptoms. Total score ranges from 0 to 3,600 being 0 the worst and 3,600 the best. A rare condition where the third portion of the duodenum is compressed between two large blood vessels the aorta and superior mesenteric artery.
The compression is usually just to the right of midline. Wilkies syndrome or superior mesenteric artery syndrome. For language access assistance, contact the ncats public information officer. Emergency laparotomy was done in view of hemodynamic instability and. The compression is caused by the superior mesenteric artery and may result in complete or partial duodenal obstruction. Research articles superior mesenteric artery syndrome. An abdominal computed tomography ct scan with contrast revealed the narrowing of the third portion of the duodenum. Endovascular treatment for superior mesenteric artery pseudoaneurysm. Superior mesenteric artery syndrome is a rare and controversial form of upper intestinal obstruction in which the third part of the duodenum is compressed by the overlying superior mesenteric artery. Superior mesenteric artery syndrome symptoms, treatment. The clinical picture is caused by compression of the 3rd part of the duodenum between the sma and aorta, which exert a clamlike or striding action on it. Superior mesenteric artery syndrome is an unusual cause of proximal intestinal obstruction. Any disease process decreasing the angle between the superior mesenteric artery and the abdominal aorta can result in the external compression of the duodenum and subsequent intestinal. Vascular imaging studies of the abdomen, including computed.
Superior mesenteric artery syndrome in a tetraplegic. Superior mesenteric artery sma syndrome is an uncommon but well recognized clinical entity characterized by compression of the third, or transverse, portion of the duodenum between the aorta and the superior mesenteric artery. Superior mesenteric artery syndrome genetic and rare. Superior mesenteric artery syndrome is a lifethreatening rare acquired upper gastrointestinal disorder due to mechanical compression of third part of duodenum by the acute angulation of superior mesenteric artery, leading to obstruction.
Mean of superior mesenteric artery syndrome is 0 points 36 %. Superior mesenteric artery syndrome sma sy or the wilkies syndrome is a very rare disorder characterized by a compression of the third portion of the duodenum by the abdominal aorta aa and. There are three main arteries that supply blood to your small and large intestines. Superior mesenteric artery an overview sciencedirect. This rare, potentially lifethreatening syndrome is typically caused by an angle of 625 between the aa and the sma, in comparison to the normal range of 3856, due to. Diseases information specialists for superior mesenteric artery syndrome. Endovascular treatment for superior mesenteric artery. Links to pubmed are also available for selected references.
Research articles will be added as they become available. Abstract superior mesenteric artery syndrome, also known as wilkies syndrome, is a rare vascular disease caused by the anomalous course of the superior mesenteric artery arising from the abdominal aorta with a smaller angle than the norm keywords. This syndrome occurs when the superior mesenteric artery pinches down on the small intestines and creates problems with digestion. Recalling superior mesenteric artery syndrome fulltext. Find your symptoms soulmates from now on you can add your symptoms in diseasemaps and find your symptoms soulmates. Zimmermanc adepartment of radiology, long island college hospital, 339 hicks street, brooklyn, ny 11201, usa bdepartment of pediatric gastroenterology, long island college hospital, 339 hicks street, brooklyn, ny 11201, usa. Symptoms vary based on severity, but can be severely debilitating. Case report superior mesenteric artery syndrome and its. To report on the need to consider the possibility of the superior mesenteric artery syndrome smas even after a long time from the initial spinal cord injury. Amazon prime days is coming up and its a great time to help the nonprofit raise a little money.
Superior mesenteric artery syndrome smas is a digestive condition that occurs when the duodenum the first part of the small intestine is compressed between two arteries the aorta and the superior mesenteric artery. What are the best treatments for superior mesenteric. Get a printable copy pdf file of the complete article 981k, or click on a page image below to browse page by page. Genetic and rare diseases information center gard po box 8126, gaithersburg, md 208988126 tollfree. Noel, in nelson pediatric symptombased diagnosis, 2018. The syndrome may be imitated or caused by an eating disorder and having to distinguish the two from each other is very important since misdiagnosis can be really dangerous.