Changing angles: Successful treatment of superior mesenteric artery syndrome with double‐balloon enteroscopy‐assisted direct feeding jejunostomy

Gutkin, Ellen; Hussain, Syed A.; Kim, Sang Ho

doi:10.1111/j.1443-1661.2012.01343.x

Cited by 2 publications

(1 citation statement)

References 4 publications

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“…Alternative nutrition like TPN or enteral feeding through jejunostomy can enhance replenishing anabolic stores [8] . However these are still invasive and not complications-free.…”

Section: Discussionmentioning

confidence: 99%

“ Less is more ”: Non operative management of short term superior mesenteric artery syndrome

Naseem¹,

Premaratne²,

Hendahewa³

2015

Annals of Medicine &Amp; Surgery

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IntroductionSuperior mesenteric artery (SMA) syndrome is a relatively rare aetiology of proximal intestinal obstruction. This is caused by narrowing of vascular angle of SMA and aorta compressing the third part of the duodenum (D3). Predisposing factors may include precipitous weight loss, corrective spinal surgery or repair of an aortic aneurysm.Presentation of caseA 53 year old male presented to our department with worsening post-prandial vomiting and epigastric pain for last three months. One examination, epigastric region was distended with succussion splash on abdominal auscultation. History did not include any predisposing factor. CT scan showed narrow angle of 12.77° between SMA and aorta owing to the compression of D3. Since onset of vomiting and resultant poor oral intake, he had lost 11 kg of his usual body weight. After gastric decompression, nasojejunal enteral feeding was started. Diet was progressed to oral feedings gradually and following return to his baseline weight, he continued to be free of symptoms in follow-up visits.DiscussionAlthough there are recognised predisposing factors but sometimes aetiology remains idiopathic. SMA syndrome should initially be managed non-operatively with gastric decompression, correction of water and electrolyte imbalance, and hemodynamic instability. Regaining weight helps increasing vascular space between SMA and D3 thus relieving obstruction. Persistence of symptoms beyond 3–4 weeks warrants surgical intervention.ConclusionNon operative management with nutritional supplementation remains the first line of therapy.

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“…Alternative nutrition like TPN or enteral feeding through jejunostomy can enhance replenishing anabolic stores [8] . However these are still invasive and not complications-free.…”

Section: Discussionmentioning

confidence: 99%

“ Less is more ”: Non operative management of short term superior mesenteric artery syndrome

Naseem¹,

Premaratne²,

Hendahewa³

2015

Annals of Medicine &Amp; Surgery

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Superior Mesenteric Artery Syndrome

Thompson

Ziegler

Trate

et al. 2017

Topics in Clinical Nutrition

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Superior mesenteric artery syndrome (SMAS) is an unusual condition where the third part of the duodenum is compressed between the superior mesenteric artery and the aorta. Certain factors increase the risk for SMAS: congenital abnormalities, weight-related conditions, and/or surgical procedures that result in alterations of the anatomy of the spine and surrounding structures, including the aorta and the superior mesenteric artery. This article provides a nutrition-focused overview of SMAS, including symptoms, diagnosis, pathophysiology, and treatment.

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Changing angles: Successful treatment of superior mesenteric artery syndrome with double‐balloon enteroscopy‐assisted direct feeding jejunostomy

Cited by 2 publications

References 4 publications

“ Less is more ”: Non operative management of short term superior mesenteric artery syndrome

“ Less is more ”: Non operative management of short term superior mesenteric artery syndrome

Superior Mesenteric Artery Syndrome

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