The Superior Mesenteric Artery Syndrome in Patients with Spinal Deformity

Altıok, Haluk; Lubicky, John P.; DeWald, Christopher J.; Herman, Jean

doi:10.1097/01.brs.0000181059.83265.b2

Cited by 55 publications

(47 citation statements)

References 18 publications

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“…The prevalence of superior mesenteric artery syndrome after scoliosis surgery has been reported to range from 0.5 to 2.4% [42, 43, 50]. In comparison, of 1,687 severely burned patients admitted from 1966 to 1970 at the Brooke Army Medical Center in Texas, 19 cases with superior mesenteric artery syndrome (1.1%) were documented [31].…”

Section: Epidemiologymentioning

confidence: 99%

“…In rare cases, the syndrome may be acute with rapid evolving upper intestinal ileus [34, 55]. Whereas patients that underwent scoliosis surgery often show symptoms within the first postoperative week [27, 42, 43] and burn patients after 2 weeks [31], other patients suffer from non-specific symptoms for months [10, 56] to years [1, 7, 8, 17]. …”

Section: Symptomsmentioning

confidence: 99%

“…The superior mesenteric artery syndrome is further a well-known complication following scoliosis surgery (see also table 1) due to a relative lengthening of the spine postoperatively. Asthenic habitus, sagittal kyphosis and postoperative weight loss have been identified as specific risk factors for development of superior mesenteric artery syndrome after scoliosis surgery [42, 43, 45]. …”

Section: Anatomy and Etiologymentioning

confidence: 99%

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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%

Section: Symptomsmentioning

confidence: 99%

Section: Anatomy and Etiologymentioning

confidence: 99%

See 1 more Smart Citation

Recalling Superior Mesenteric Artery Syndrome

Welsch

Büchler²,

Kienle³

2007

Dig Surg

340

474

View full text Add to dashboard Cite

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“…The SMA-aorta distance in our patient was 6 mm at disease onset and 9 mm at the time of remission. SMA syndrome may develop when the anatomical relationships between the third portion of the duodenum, spine, aorta and SMA are distorted by weight loss, spinal traction or lumber hyperlordosis (12,13). One main cause of SMA syndrome is significant weight loss due to an eating disorder.…”

Section: Discussionmentioning

confidence: 99%

Suspicion of Superior Mesenteric Artery Syndrome in a Patient with Severe Gastric Dilatation after Catheter Ablation

et al. 2015

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Catheter ablation is a widely used treatment for atrial fibrillation. Gastric hypomotility due to periesophageal vagal plexus injury is a consequence of the extracardiac penetration of ablative energy. Some affected patients develop severe gastric dilatation requiring hospitalization. However, most previous reports have stated the cause of the subject's condition to be "unknown" or described the symptoms using obscure terms, such as "paralytic" or "gastroparesis." For example, one report stated that a few sites of severe gastric dilatation were secondary to "pyloric spasms;" however, no illustrations were provided in the paper. "Superior mesenteric artery syndrome" is a suspected cause of such dilatation.

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“…Осложнения со стороны желудочно-кишечного тракта после операций на позвоночнике 12-перстной кишки а. mesenterica superior. Распространенность данной патологии составляет 0,5-0,6 % сре-ди пациентов, прооперированных по поводу патологии позвоночника [15,16,20,21]. Развитие синдрома обу-словлено уменьшением угла отхожде-ния а. mesenterica superior от аорты в результате анатомических особен-ностей строения сосудистого рус-ла и корригирующих воздействий в ходе хирургического вмешатель-ства [19].…”

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Analysis of Gastrointestinal Complications After Spinal Deformity Surgery

Vissarionov¹,

Korsun²,

Syundyukov³

et al. 2015

Hir. pozvonoč.

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Objective. To assess the rate of gastrointestinal tract disorders in children with spinal deformities in the early postoperative period after surgical intervention, and to compare results of different diagnostics schemes and preventive treatment. Material and Methods. The treatment outcomes in 125 patients aged 13 to 18 years admitted for surgical treatment of scoliosis and Scheuermann's disease were analyzed. In Group I endoscopic examinations were performed in all patients before surgery and only in those with clinical manifestations in the postoperative period. In Group II examinations were performed in all patients before and after surgery regardless of clinical signs. Prevention of gastrointestinal complications was standard in Group I and extended in Group II. Results. The incidence of gastrointestinal tract pathology was 98 % in Group I and 86 % in Group II. Patients in Group II had no severe (grade 3 and 4) erosive lesions in the postoperative period, the rate of grade 2 lesions decreased to 31 %. Erosive lesions were more frequent in patients with low body mass index (53.8 %). Conclusion. Gastrointestinal tract disorders are a common problem in patients with spinal deformity after corrective interventions. It is advisable to carry out endoscopy and ultrasound examinations in the postoperative period to optimize preventive and curative measures for avoidance of severe lesions of the gastrointestinal tract. Key Words: gastrointestinal tract, gastric mucosa, stress ulcers, superior mesenteric artery syndrome, scoliosis, children. Цель исследования. Оценка частоты нарушений со сто-роны желудочно-кишечного тракта, возникающих в ран-нем послеоперационном периоде у детей с деформация-ми позвоночника после хирургического вмешательства, сравнение результатов различных схем диагностики и профилактического лечения. Материал и методы. Проведен анализ результатов лечения 125 пациентов 13-18 лет, поступивших на оперативное лечение по поводу идиопатического сколиоза и болезни Шейерманна. В первой группе эндоскопические иссле-дования проводили всем пациентам до операции и при наличии клинических проявлений в послеоперационном периоде, во второй группе -всем пациентам до и после операции, вне зависимости от клиники. В первой группе профилактику осложнений со стороны ЖКТ проводили по стандартной схеме, во второй -по расширенной. Результаты. Патология со стороны ЖКТ встречалась в 98 % случаев в первой группе и в 86 % во второй. У па-циентов второй группы в послеоперационном периоде тяжелых поражений 3-го и 4-го уровней не наблюдалось, поражения 2-го уровня снизились до 31 %. Эрозивные поражения чаще встречались у пациентов с низким ин-дексом массы тела -53,8 % случаев. Заключение. Нарушения со стороны желудочно-кишеч-ного тракта у пациентов с деформацией позвоночника после корригирующих вмешательств являются частой проблемой. Целесообразно проводить эндоскопическое исследование и УЗИ в послеоперационном периоде для оптимизации профилактических и лечебных меро-приятий по предотвращению тяжелых поражений же-лудочно-кишечног...

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The Superior Mesenteric Artery Syndrome in Patients with Spinal Deformity

Cited by 55 publications

References 18 publications

Recalling Superior Mesenteric Artery Syndrome

Recalling Superior Mesenteric Artery Syndrome

Suspicion of Superior Mesenteric Artery Syndrome in a Patient with Severe Gastric Dilatation after Catheter Ablation

Analysis of Gastrointestinal Complications After Spinal Deformity Surgery

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