Intermittent Arteriomesenteric Occlusion of the Duodenum

Goin, Lowell S.; Wilk, Stefan

doi:10.1148/67.5.729

Cited by 55 publications

(27 citation statements)

References 9 publications

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“…In the general population, the prevalence of superior mesenteric artery syndrome was estimated at around 0.013–0.3% on the basis of upper gastrointestinal barium studies [4, 51, 52], underlining its rarity. Interestingly, the prevalence in a chronic-care hospital (0.965/1,000 admissions) was significantly higher than that in acute general hospitals (0.0108–0.0520/1,000 admissions) [6].…”

Section: Epidemiologymentioning

confidence: 99%

Recalling Superior Mesenteric Artery Syndrome

Welsch

Büchler²,

Kienle³

2007

Dig Surg

340

474

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Background: Superior mesenteric artery syndrome is uncommon and characterized by postprandial epigastric pain, nausea, vomiting, anorexia and weight loss. The syndrome is caused by compression of the third part of the duodenum in the angle between the aorta and the superior mesenteric artery. This review updates etiology, epidemiology, diagnosis, treatment and outcome of the superior mesenteric artery syndrome. Methods: Review of the literature. Results: Frequently, predisposing medical conditions associated with catabolic states or rapid weight loss result in a decrease of the aortomesenteric angle and subsequent duodenal obstruction. External cast compression, anatomic variants and surgical alteration of the anatomy following spine surgery or ileoanal pouch anastomosis can also precipitate the syndrome. Once radiologic studies have established diagnosis, first-line treatment is usually conservative with jejunal or parenteral nutrition for restoration of the aortomesenteric fatty tissue. If conservative management fails, surgical options include open or laparoscopic duodenojejunostomy or duodenal mobilization and division of the ligament of Treitz. Conclusion: Superior mesenteric artery syndrome is clearly defined and frequently associated with a wide range of predisposing conditions and surgical procedures; clinicians have to consider this syndrome in such a setting. Larger studies are needed to better define the optimal treatment for this disease.

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Section: Epidemiologymentioning

confidence: 99%

Recalling Superior Mesenteric Artery Syndrome

Welsch

Büchler²,

Kienle³

2007

Dig Surg

340

474

View full text Add to dashboard Cite

show abstract

“…SMA syndrome is an uncommon but distinct clinical condition mostly affecting women between the ages of 10 and 305. There are three predisposing anatomical variants: (1) a sharp angle between the abdominal aorta and the SMA, (2) a short ligament of Treitz with fixation of the duodenum beneath the SMA, and (3) an aberrant SMA situated downwards and forwards.…”

Section: Discussionmentioning

confidence: 99%

Refractory coeliac disease: or is it?

Amadi¹,

Anderson

2017

BMJ Case Reports

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A previously healthy 33-year-old man presented with a 3-month history of nausea, anorexia and weight loss. Coeliac disease was diagnosed at another hospital with positive serology and D2 biopsies and he was started on a gluten-free diet. The details of these tests were not available to us. Despite good adherence to a gluten-free diet, he continued to lose weight and became anaemic. A repeat gastroscopy showed D2 ulcers. infection was excluded, coeliac serology remained negative but D2 biopsies showed partial duodenal villous flattening with intraepithelial lymphocytosis. Type 1 refractory coeliac disease was diagnosed. Prednisolone and azathioprine were commenced but the vomiting and weight loss progressed. A subsequent gastroscopy and CT scan revealed a D3 stricture and duodenal dilatation, respectively, in keeping with superior mesenteric artery syndrome. An infracolic duodenojejunostomy was performed and immunosuppression stopped. Subsequently, all his symptoms resolved and he remains well on a gluten-free diet.

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“…In an upper gastrointestinal contrast study the incidence of SMAS was reported to be approximately 0.2%; however, the actual prevalence of SMAS remains unclear (12)(13)(14). To the best of our knowledge, there are only three reports on diabetes complicated by SMAS (14-16).…”

Section: Discussionmentioning

confidence: 99%

Superior Mesenteric Artery Syndrome Complicated by Diabetic Ketoacidosis and Graves' Disease in Slowly Progressive Insulin Dependent Diabetes Mellitus (SPIDDM): A Case Report and a Review of the Literature

et al. 2016

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A 48-year-old woman with a history of diabetes was admitted for nausea and vomiting with body weight loss. A blood examination revealed high plasma glucose and thyroid hormone levels and metabolic acidosis. She was therefore diagnosed with both diabetic ketoacidosis (DKA) and hyperthyroidism. Nausea and vomiting continued intermittently despite the administration of saline and insulin. The patient was further diagnosed with superior mesenteric artery syndrome (SMAS) after abdominal computed tomography revealed that a horizontal portion of the duodenum was sandwiched between the aorta and the superior mesenteric artery. Clinicians should be vigilant for SMAS in patients with both DKA and hyperthyroidism who present body weight loss.

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Intermittent Arteriomesenteric Occlusion of the Duodenum

Cited by 55 publications

References 9 publications

Recalling Superior Mesenteric Artery Syndrome

Recalling Superior Mesenteric Artery Syndrome

Refractory coeliac disease: or is it?

Superior Mesenteric Artery Syndrome Complicated by Diabetic Ketoacidosis and Graves' Disease in Slowly Progressive Insulin Dependent Diabetes Mellitus (SPIDDM): A Case Report and a Review of the Literature

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