A Case Series on Superior Mesenteric Artery Syndrome Surgical Management, Single Institution Experience

Valiathan, Gopakumar C.; Wani, Majid; Lanker, Juneed M.; Reddy, Prasanna Kumar

doi:10.7860/jcdr/2017/20248.10402

Cited by 10 publications

(7 citation statements)

References 15 publications

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“…A prospective study in a single institution has been reported that SMA syndrome patients underwent duodenojejunostomy or performed a distal duodenum resection [1]. Laparoscopic duodenojejunostomy is considered to be feasible, safe, less morbid and effective for SMA syndrome compared with open surgery [14, 15]. Even for SMA syndrome combined with Nutcracker syndrome due to severe weight reduction, weight gain and SMA syndrome was corrected by laparoscopic duodenojejunostomy [16].…”

Section: Discussionmentioning

confidence: 99%

Superior mesenteric artery syndrome coexists with Nutcracker syndrome in a female: a case report

Shi

et al. 2019

BMC Gastroenterol

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BackgroundSuperior mesenteric artery (SMA) syndrome, also known as Wilkie’s syndrome or Benign duodenal stasis, is a rare benign disease. It could threaten the life if the manifestation is severe and the treatment is inappropriate. In the patients with SMA syndrome, the third portion (transverse part) of the duodenum is compressed externally between the SMA and abdominal aorta (AA) leading to duodenal stasis and gastrointestinal obstruction. SMA syndrome may rarely combine with Nutcracker syndrome when left renal vein (LRV) was compressed between SMA and AA.Case presentationA 32-year-old female patient presented with complaints of gradually severe bloating, epigastric pain, left flank ache, nausea and occasional vomiting of 1 month’s duration. The epigastric and left flank ache was aggravated when the patient was supine and relieved in a prone or left lateral decubitus. The abdominal bloating was associated with early satiety. The vomiting always started 40 min after meal. The patient gave a history of urine stone with drotaverine hydrochloride tablets treatment for two weeks before the gastrointestinal symptoms arising. The patient had no significant surgical history, but had a rapid weight loss of approximately 10 kg with a body mass index (BMI) from 21 kg/m2 to less than 18 kg/m2 over the last two months. An abdominal examination revealed upper abdominal tenderness and distention. The urine routine examination showed no significant abnormality. The findings of initial blood tests and other laboratory investigations were unremarkable.ConclusionsThis case reports a female patient with SMA syndrome with Nutcracker syndrome predisposed by Antispasmodics. We highlight the importance of the combination therapy of long-term nutritional supporting and prokinetic agents. Rehabilitating practice after discharge is beneficial to reduce recurrence.

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Section: Discussionmentioning

confidence: 99%

Superior mesenteric artery syndrome coexists with Nutcracker syndrome in a female: a case report

Shi

et al. 2019

BMC Gastroenterol

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“…Ultimately, in those who do not improve with conservative management, the surgical options include mobilization of ligament of Treitz (Strong's procedure) [7], gastrojejunostomy, and laparoscopic duodenojejunostomy. Of those options, duodenojejunostomy may provide the best results [8], which is reflected in the successful outcome in our patient. In summary, physicians should be wary of this rare etiology of duodenal obstruction and its clinical manifestations.…”

Section: Discussionmentioning

confidence: 63%

Wilkie’s Syndrome following Chemotherapy: A Case Report and a Review of Literature

Corsi

Abu-Heija

Ravi

et al. 2022

Case Reports in Gastrointestinal Medicine

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Superior mesenteric artery (SMA) syndrome is a rare etiology of upper gastrointestinal obstruction. The measured angle between the SMA and the aorta is typically between 38 and 65° and maintained by mesenteric fat. Excessive fat loss can lead to intestinal obstruction due to an exaggerated acute angularity of the SMA, compressing the third part of the duodenum. We present a 22-year-old female with a history of aplastic anemia, status post bone-marrow transplant, who presented with intractable nausea and had confirmed SMA syndrome on CT angiography. Subsequently, the patient underwent nasogastric decompression and successful laparoscopic duodenojejunostomy.

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“…3) [12]. Of the included 35 publications, 24 studies focused on surgical therapy for CAS and 11 on SMAS [5,[37][38][39][40][41][42][43][44][45][46].…”

Section: Resultsmentioning

confidence: 99%

Surgical therapy of celiac axis and superior mesenteric artery syndrome

Jonas

Ghafoor

Kobe

et al. 2023

Langenbecks Arch Surg

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Introduction Compression syndromes of the celiac artery (CAS) or superior mesenteric artery (SMAS) are rare conditions that are difficult to diagnose; optimal treatment remains complex, and symptoms often persist after surgery. We aim to review the literature on surgical treatment and postoperative outcome in CAS and SMAS syndrome. Methods A systematic literature review of medical literature databases on the surgical treatment of CAS and SMAS syndrome was performed from 2000 to 2022. Articles were included according to PROSPERO guidelines. The primary endpoint was the failure-to-treat rate, defined as persistence of symptoms at first follow-up. Results Twenty-three studies on CAS (n = 548) and 11 on SMAS (n = 168) undergoing surgery were included. Failure-to-treat rate was 28% for CAS and 21% for SMAS. Intraoperative blood loss was 95 ml (0–217) and 31 ml (21–50), respectively, and conversion rate was 4% in CAS patients and 0% for SMAS. Major postoperative morbidity was 2% for each group, and mortality was described in 0% of CAS and 0.4% of SMAS patients. Median length of stay was 3 days (1–12) for CAS and 5 days (1–10) for SMAS patients. Consequently, 47% of CAS and 5% of SMAS patients underwent subsequent interventions for persisting symptoms. Conclusion Failure of surgical treatment was observed in up to every forth patient with a high rate of subsequent interventions. A thorough preoperative work-up with a careful patient selection is of paramount importance. Nevertheless, the surgical procedure was associated with a beneficial risk profile and can be performed minimally invasive.

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A Case Series on Superior Mesenteric Artery Syndrome Surgical Management, Single Institution Experience

Cited by 10 publications

References 15 publications

Superior mesenteric artery syndrome coexists with Nutcracker syndrome in a female: a case report

Superior mesenteric artery syndrome coexists with Nutcracker syndrome in a female: a case report

Wilkie’s Syndrome following Chemotherapy: A Case Report and a Review of Literature

Surgical therapy of celiac axis and superior mesenteric artery syndrome

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