Superior mesenteric artery syndrome: CT findings

Biswas, Asthik; Babu, Arul Arokia Sensan; Neelakantan, Sankar; Sarkar, Partha Sarathi

doi:10.1136/bcr-2016-215885

Cited by 17 publications

(18 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this syndrome, the 3rd part of duodenum will be compressed between SMA at its origin and abdominal aorta due to decreased angulation leading to partial or complete obstruction [1].…”

Section: Discussionmentioning

confidence: 99%

Superior mesenteric artery syndrome: A diagnosis to be kept in mind (Case report and literature review)

Salem

Al-Ozaibi

Nassif

et al. 2017

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

show abstract

“…In this syndrome, the 3rd part of duodenum will be compressed between SMA at its origin and abdominal aorta due to decreased angulation leading to partial or complete obstruction [1].…”

Section: Discussionmentioning

confidence: 99%

Superior mesenteric artery syndrome: A diagnosis to be kept in mind (Case report and literature review)

Salem

Al-Ozaibi

Nassif

et al. 2017

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

show abstract

“…Several exams can be performed to rule out other causes of upper intestinal obstruction, including computerized tomography of the abdomen, upper oral contrast series and esophagogastroduedonoscopy [6,9]. In this case, abdominal CT did not suggest SMAS and UGS demonstrated duodenal obstruction.…”

Section: Discussionmentioning

confidence: 99%

“…The superior mesenteric artery syndrome results from the formation of an abnormal acute angle measuring between 7 o and 22 o and may have different causes, such as increased lumbar lordosis or use of orthotics for correcting posture [11]. Another important etiology of this syndrome is the loss of fat tissue close to the superior mesenteric artery and can to occur due to malnutrition, malignancy, diabetes mellitus, AIDS, heart diseases or neuropathy, abnormal insertion of the ligament of Treitz, abdominal aorta aneurism or tumor at the root of the mesenterium [6,8,12]. An infrequent cause associated to this syndrome is height growth in adolescence with no proportional weight gain [8].…”

Section: Discussionmentioning

confidence: 99%

“…Angiography is the main diagnostic examination and enables measuring the aortomesenteric angle, but the gold standard examination is CT angiography and 3D-reconstruction [6,10]. Several exams can be performed to rule out other causes of upper intestinal obstruction, including computerized tomography of the abdomen, upper oral contrast series and esophagogastroduedonoscopy [6,9].…”

Section: Discussionmentioning

confidence: 99%

“…In most cases, the onset is insidious with postprandial nausea and vomiting, pain mainly in the epigastrium and weight loss [5]. As to diagnostic exams the gold standard examination is CT angiography and 3D-reconstruction but Upper gastrointestinal series (UGS) is a simple examination and can diagnose this syndrome as well [6]. The surgical treatment of WS should be performed after a conservative treatment that includes fluid and electrolyte replacement, hydration and appropriate nutritional support.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Wilkie’s Syndrome in an Adolescent: A Rare Etiology of Upper Intestinal Obstruction

Roriz-Silva¹,

Maranhão²,

Krp³

2017

Journal of Case Reports and Studies

View full text Add to dashboard Cite

Wilkie's Syndrome (WS) was described in 1927 and its physiopathology is related to the formation of an abnormal acute aortomesenteric angle measuring between 7 o and 22 o . It leads to digestive symptoms due to external compression of mesentery artery against the third portion of duodenum. This is a case of WS in a young, tall and slim male patient. Three months before, he began postprandial vomiting, abdominal pain, hyporexia and weight loss. The diagnostis was made by an upper gastrointestinal series with barium contrast and confirmed by Laparotomy. Duodenojejunostomy is a well-known technique and it was successfully performed in this case. Case ReportKeywords: Wilke's Syndrome; Superior Mesenteric Artery Syndrome; Mesenteric Duodenal Compression Syndrome; Duodenal Obstruction; Surgery; Duodenojejunostomy Wilkie's syndrome or Superior Mesenteric Artery Syndrome is a rare condition of upper intestinal obstruction. In the general population, the incidence is from 0.013 to 0.3% [1]. This disorder is characterized by extrinsic compression of the third portion of the duodenum due to an abnormal acute angle between the aorta and the superior mesenteric artery, or due to presence of an overlapping of the ligament of Treitz in the retroperitoneum [1]. The syndrome has been known since 1842 and was first described by Carl Von Rokitansky [2]. In 1878, Willet reported a case of death secondary to what he named fatal vomiting [3]. In 1927, Doctor Wilkie described a series of 75 patients with the so-called "duodenal ileus", and 64 of them were submitted to duodenojejunostomy that confirmed the mechanism of extrinsic duodenal compression [4]. In most cases, the onset is insidious with postprandial nausea and vomiting, pain mainly in the epigastrium and weight loss [5]. As to diagnostic exams the gold standard examination is CT angiography and 3D-reconstruction but Upper gastrointestinal series (UGS) is a simple examination and can diagnose this syndrome as well [6]. The surgical treatment of WS should be performed after a conservative treatment that includes fluid and electrolyte replacement, hydration and appropriate nutritional support. The main surgical option is duodenojejunostomy [5,7]. The aim of this study is to report a rare case of upper bowel obstruction (Wilkie's Syndrome) in an adolescent and make important considerations about its pathophysiology, diagnosis and treatment.A male patient, 17-year of age, slim, height 1.8 meters (5 ft 11 in), weight 54 Kg (119 Ib), and BMI of 16.7. The patient presented with postprandial vomiting and abdominal pain, cramps in the mesogastrium which began three months previously and were concurrent with hyporexia and weight loss over 17 kg during that period. He was admitted to the Division of General Surgery of the Hospital de Base, in the city of Porto Velho, Brazil and physical examination showed malnutrition status with emaciation -grade 3 -according to World Health Organization. Laboratory tests revealed some alterations -low hemoglobin and albumin. An abdominal plain CT showe...

show abstract

Normal values of angle and distance between the superior mesenteric artery and aorta in Iraqi population: A single centre study

Hadi

Kareem

Kamal

2021

J of Medical Radiation Sci

View full text Add to dashboard Cite

Introduction The diagnosis of the superior mesenteric syndrome depends on measuring the distance and angle between the superior mesenteric artery (SMA) and aorta on CT scan in the presence of duodenal compression. Studies examining the normal range of these measurements are scarce and none of them was conducted on the Iraqi population. The aim of this study was to assess the values of aorto‐SMA angle (AMA) and aorto‐SMA distance (AMD) in asymptomatic patients to define the normal range in the Iraqi population and to compare it with the normal published range and different demographical values and body mass index (BMI). Methods A total of 333 patients referred to arterial phase CT examinations for reasons unrelated to gastrointestinal tract were recruited. On axial and reformatted sagittal–oblique images, the angle and the distance between SMA and aorta were measured at the location where the duodenum crosses. Results Both AMA and AMD had a wider range 10–147° and 4–44 mm, respectively, compared to the literature reported range. There was a significant reduction in AMA and AMD values in underweight participants (AMA, P < 0.001; and AMD, P = 0.014) and in female patients (AMA and AMD, P < 0.0001) and those who were younger than 20 (AMA, P = 0.014; and AMD, P = 0.001). A moderate correlation (r = 0.507, P < 0.0001) was found between AMA and AMD values. The correlation of BMI with AMD values was moderate (r = 0.46), and with AMA was weak (r = 0.23) (P < 0.0001). Conclusion Very low values of AMA and AMD can occur in normal asymptomatic patients without compressing the duodenum, which warrants further follow‐up studies. Evaluating normal values of AMA and AMD in the Iraqi population can help in providing a reference for CT‐based diagnosis of SMA syndrome.

show abstract

Superior mesenteric artery syndrome: CT findings

Cited by 17 publications

References 5 publications

Superior mesenteric artery syndrome: A diagnosis to be kept in mind (Case report and literature review)

Superior mesenteric artery syndrome: A diagnosis to be kept in mind (Case report and literature review)

Wilkie’s Syndrome in an Adolescent: A Rare Etiology of Upper Intestinal Obstruction

Normal values of angle and distance between the superior mesenteric artery and aorta in Iraqi population: A single centre study

Contact Info

Product

Resources

About