Laparoscopic management of a complicated case of Wilkie’s syndrome: A case report

Khodear, Yehya; Al‐Ramli, Wisam; Bodnár, Zsolt

doi:10.1016/j.ijscr.2017.06.033

Cited by 8 publications

(12 citation statements)

References 5 publications

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“…6 These conservative measures include NGT decompression, rehydration, electrolyte replacement, and, most important, the use of total parental nutrition or aggressive nutritional support. 7,8 When conservative management fails, enteral feeding through surgical gastrojejunostomy can be performed. 9 The advantage of EUS-GJ is that it offers a minimally invasive intervention without the morbidities associated with surgery or the placement of an external feeding tube.…”

Section: Discussionmentioning

confidence: 99%

Reverse Endoscopic Ultrasound-Guided Gastrojejunostomy for the Treatment of Superior Mesenteric Artery Syndrome: A New Concept

Dawod

Gaidhane

et al. 2020

Clin Endosc

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Superior mesenteric artery syndrome (SMAS) causes compression and partial or complete obstruction of the duodenum, resulting in abdominal pain, nausea, vomiting, and weight loss. If conservative therapy fails, the patient is typically referred for enteral feeding or laparoscopic gastrojejunostomy. The last few years have seen increasing use of endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) for gastric obstruction indications. EUS-GJ involves the creation of a gastric bypass via an echoendoscope in cases in which the small intestine can be punctured under ultrasonographic visualization, resulting in an incision-free, efficient, and safe procedure. In this case report, we present the first case of SMAS treated using a reverse EUS-GJ, and describe the steps and advantages of the procedure in this particular case. Clin Endosc 2020;53:94-96

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Section: Discussionmentioning

confidence: 99%

Reverse Endoscopic Ultrasound-Guided Gastrojejunostomy for the Treatment of Superior Mesenteric Artery Syndrome: A New Concept

Dawod

Gaidhane

et al. 2020

Clin Endosc

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“…Although conservative management is the standard treatment for uncomplicated cases of SMA syndrome, there is no clear time limit for this treatment and there have been reports of treatment lasting up to 169 days [ 18 , 19 ]. In the case of failure of conservative management, surgical intervention as gastrojejunostomy, duodenojejunostomy, or division of the ligament of Treitz can be performed [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Superior mesenteric artery syndrome caused by acute weight loss in a 16-year-old polytrauma patient: A rare case report and review of the literature

Esmat

Najah

2021

Annals of Medicine &Amp; Surgery

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Introduction Superior mesenteric artery syndrome is a rare entity, caused by compression of the duodenum between the superior mesenteric artery and the aorta. Case presentation A 16-year-old male in the inpatient service of our hospital complained of vomiting for two weeks. The patient had a long hospital stay in our center for the management of trauma-related complications, which resulted in significant weight loss despite the parenteral nutrition as he was unable for taking the enteral nutrition due to severe facial traumatic injury. In oral contrast study, the proximal duodenal segments were dilated. The contrast media could not reach the duodenojejunal junction in the supine position, though a small amount of the contras passed the distal duodenal part on repositioning the patient to prone. On abdominal CT images, the angle and distance between the superior mesenteric artery and the abdominal aorta were decreased to 20. 8 0 , and 7.3 mm respectively. The findings were consistent with the superior mesenteric artery compression syndrome. He underwent a mini-laparotomy for the placement of a jejunostomy feeding tube aiming to promote weight gain and mesenteric fat restoration for preventing the SMA compression effects on the duodenum. Discussion The decrease in retroperitoneal fat owing to weight loss may result in aortomesenteric angle reduction and duodenal compression. Prompt nutritional support and timely diagnosis may preclude the need for more invasive surgical intervention. Conclusion Superior mesenteric artery syndrome is a rare condition, often resulting in small bowel obstruction. The clinical symptoms of this syndrome are nonspecific, which may underestimate the diagnosis. However, clinical suspicion supported by imaging study may help the accurate diagnosis. Superior mesenteric artery syndrome should be considered in all polytrauma and longstanding immobile patients present with rapid weight loss and vomiting.

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“…As etiologias mais frequentes resultam de perda ponderal significativa secundária a outras patologias 2,5 . Dessa maneira, ocorre a depleção da gordura perimesentérica e retroperitoneal, diminuindo o ângulo aorto-mesentérico 1 . Provável causa da perda ponderal acentuada no nosso caso foi a aderência firme supracitada com obstáculo da passagem de bolo alimentar para 2º porção duodenal com vômitos frequentes.…”

Section: Discussionunclassified

“…

Superior (SAMS) ou Síndrome de Wilkie é uma afecção rara, com prevalência na população geral de 0,013% a 0,3%, sendo mais frequente em mulheres jovens, entre 20 e 40 anos de idade 1 . Caracteriza-se pela obstrução da terceira porção do duodeno pela artéria mesentérica superior, anteriormente, e pela aorta e coluna vertebral, posteriormente [1][2][3][4][5][6] .A causa mais frequente dessa patologia é a perda ponderal significativa ocasionada por doenças agudas ou crônicas. O quadro clínico é composto por dor e distensão abdominal pós-prandial, náuseas, vômitos e emagrecimento acentuado 2 .

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Síndrome da artéria mesentérica superior com estenose arterial mesentérica superior crônica como complicação tardia de colecistectomia

Nakanishi¹,

Barile²,

Granato³

et al. 2020

Relatos Casos Cir

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A Síndrome da Artéria Mesentérica Superior ou de Wilkie é uma causa rara de obstrução duodenal e resulta da compressão da terceira porção do duodeno pela artéria mesentérica superior e pela artéria aorta. É apresentado o caso de uma mulher de 49 anos de idade, com sintomatologia de dor e distensão pós-prandial e perda ponderal com doze meses de evolução após a colecistectomia. Após investigação e exclusão de outras patologias, é diagnosticada esta síndrome associada à estenose crítica oclusão arterial crônica da Artéria Mesentérica Superior. O caso demonstra o quadro clínico, o estudo diagnóstico e as opções terapêuticas.

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Laparoscopic management of a complicated case of Wilkie’s syndrome: A case report

Cited by 8 publications

References 5 publications

Reverse Endoscopic Ultrasound-Guided Gastrojejunostomy for the Treatment of Superior Mesenteric Artery Syndrome: A New Concept

Reverse Endoscopic Ultrasound-Guided Gastrojejunostomy for the Treatment of Superior Mesenteric Artery Syndrome: A New Concept

Superior mesenteric artery syndrome caused by acute weight loss in a 16-year-old polytrauma patient: A rare case report and review of the literature

Síndrome da artéria mesentérica superior com estenose arterial mesentérica superior crônica como complicação tardia de colecistectomia

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