Superior mesenteric artery syndrome and the ‘nutcracker phenomenon’

Vulliamy, Paul; Hariharan, Vimal; Gutmann, Jacques; Mukherjee, Dipankar

doi:10.1136/bcr-2013-008734

Cited by 27 publications

(17 citation statements)

References 3 publications

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“…Females, older children, and adolescents are most commonly affected (http//.www.learning radiology.com). The condition most commonly affects underweight individuals with a history of rapid weight loss [11]. Proposed etiological factors being constitutional factors like thin body build exaggerated lumbar lordosis; depletion of the mesenteric fat by rapid severe weight loss due to catabolic states such as cancer, surgery, trauma, burns, or psychiatric problems; or due to dietary disorders like anorexia nervosa or malabsorption.…”

Section: Discussionmentioning

confidence: 99%

Measurement of the Distance and Angle Between the Aorta and Superior Mesenteric Artery on CT Scan: Values in Indian Population in Different BMI Categories

et al. 2013

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The primary intention of the study was to "prove" that the reduced angle and distance between the superior mesenteric artery (SMA) and aorta significantly correlates with reduced body mass index (BMI). This in turn indicates the strong etiological role of this factor for causation of SMA syndrome. (Most literature till date still mentions sudden depletion of fat pad between the vessels as a "proposed predisposing factor"). The superior mesenteric artery syndrome is characterized by the compression of the third segment of the duodenum by the mesentery at superior mesenteric artery level and a resulting duodenal (±gastric) dilatation. The disease is closely related with the depletion of the fat pad between the vessels narrowing the angle and reducing the distance between the vessels. A prospective study of 100 patients (58 males and 42 females) in the age range 15-85 years (mean age 50 years) who had undergone CT scan for various other complaints. CT scan had been performed with routine protocol comprising plain phase followed by arterial and venous phase by measuring the angle between the aorta and superior mesenteric artery, and also BMI was calculated. Mean values for distance and angle were obtained with standard deviation and 95 % confidence intervals. Pearson coefficients were also calculated and results tabulated. A strong positive correlation exists between BMI and the angle between the aorta and SMA. With increment in BMI, the angle also increases so less chance of developing superior mesenteric artery syndrome.

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Section: Discussionmentioning

confidence: 99%

Measurement of the Distance and Angle Between the Aorta and Superior Mesenteric Artery on CT Scan: Values in Indian Population in Different BMI Categories

et al. 2013

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“…The summarized cases are shown in Table 1. [14][15][16][17][18][19][20] In our case, the patient's body mass index was relatively high, and surgical intervention to treat SMA syndrome was used uniquely. In all cases, the specific therapy for renal nutcracker syndrome was not needed due to the lack of hematuria or serious urinary symptoms, and the symptoms related to SMA syndrome were well resolved after treatment.…”

Section: 오명진 콩팥 호두까기 증후군이 동반된 위창자간막동맥 증후군 1예mentioning

confidence: 88%

Superior Mesenteric Artery Syndrome Combined with Renal Nutcracker Syndrome in a Young Male: A Case Report

2017

Korean J Gastroenterol

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Superior mesenteric artery (SMA) syndrome is one of the rare causes of small bowel obstruction. It develops following a marked decrease in the angle between SMA and the abdominal aorta due to weight loss, anatomical anomalies, or following surgeries. Nutcracker syndrome in the left renal vein may also occur following a decrease in the aortomesenteric angle. Though SMA syndrome and renal nutcracker syndrome share the same pathogenesis, concurrent development has rarely been reported. Herein, we report a 23-year-old healthy male diagnosed with SMA syndrome and renal nutcracker syndrome due to severe weight reduction. The patient visited our outpatient clinic presenting bilious vomiting and indigested vomitus for 3 consecutive days. He had lost 20 kg during military service. We suspected SMA syndrome based on abnormal air-shadow in the stomach and small bowel on abdominal X-ray; we confirmed compression of the third portion of the duodenum with upper gastrointestinal series and abdominal computed tomography (CT). Concurrently, renal nutcracker syndrome was also detected via abdominal CT and Doppler ultrasound. Considering bilious vomiting and no urinary symptoms, SMA syndrome was corrected by laparoscopic duodenojejunostomy, and close observation for the renal nutcracker syndrome was recommended. (Korean J Gastroenterol 2017;70:253-260)

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“…При математической обработке данных МРТ-и КТ-флебографии определяли критерии аортомезентериальной и подвздошной венозной (вертеброартериальной) компрессии. Критерии аортомезентериальной компрессии включали в себя определение величины аортомезентери-ального угла (aortomesenteric angle, AMA) (нор-ма -28-65°) и величины аортомезентериальной дистанции (aortomesenteric distance, AMD) (нор-ма -10-34 мм) [6,7]. Критерии подвздошной венозной (вертеброартериальной) компрессии включали в себя определение величины нижне-го люмбарного лордозного угла (lower lumbar lordosis angle, LLLA) (норма -134,33-136,76°) и диаметра подвздошного венозного туннеля (diameter of the iliac vein tunnel, IVTD) (норма -4,18-4,50 мм) [8].…”

Section: материалы и методы исследованияunclassified

Endovascular surgery of the iliac veins with bilateral varicocele and varicose veins of the pelvic organs in men

Kapto

2018

Urolog vedom

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In this study an analysis of the examination and treatment of 66 patients with bilateral varicocele, varicose veins of the pelvic organs due to ileal venous compression was performed. The obtained data testify to the need to review existing approaches to the surgical treatment of bilateral and recurrent varicocele. Carrying out balloon angioplasty and stenting in varicose veins of the pelvic veins in men due to the syndrome of ileal venous compression is currently an innovative and promising direction in urological practice at the interface of specialties. (For citation: Kapto AA. Endovascular surgery of the iliac veins with bilateral varicocele and varicose veins of the pelvic organs in men. Urologicheskie vedomosti. 2018;8(1):11-17. doi: 10.17816/uroved8111-17).

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Superior mesenteric artery syndrome and the ‘nutcracker phenomenon’

Cited by 27 publications

References 3 publications

Measurement of the Distance and Angle Between the Aorta and Superior Mesenteric Artery on CT Scan: Values in Indian Population in Different BMI Categories

Measurement of the Distance and Angle Between the Aorta and Superior Mesenteric Artery on CT Scan: Values in Indian Population in Different BMI Categories

Superior Mesenteric Artery Syndrome Combined with Renal Nutcracker Syndrome in a Young Male: A Case Report

Endovascular surgery of the iliac veins with bilateral varicocele and varicose veins of the pelvic organs in men

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