The Two Sides of Superior Mesenteric Artery Compression Treatment: Conservative or Surgical Management?

Rodríguez, Elvia Johanna Osegueda de; Hernández-Villegas, A.C.; Serralde‐Zúñiga, Aurora E.; Reyes-Ramírez, A.L.

doi:10.20960/nh.1006

Cited by 11 publications

(9 citation statements)

References 4 publications

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“…Treatment of SMA syndrome initially involves conservative management. However, surgical intervention will be requited if medical treatment fails or the condition is severe [13]. The alternative operations mainly included open duodenojejunostomy and laparoscopic duodenojejunostomy.…”

Section: Discussionmentioning

confidence: 99%

Superior mesenteric artery syndrome coexists with Nutcracker syndrome in a female: a case report

Shi

et al. 2019

BMC Gastroenterol

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BackgroundSuperior mesenteric artery (SMA) syndrome, also known as Wilkie’s syndrome or Benign duodenal stasis, is a rare benign disease. It could threaten the life if the manifestation is severe and the treatment is inappropriate. In the patients with SMA syndrome, the third portion (transverse part) of the duodenum is compressed externally between the SMA and abdominal aorta (AA) leading to duodenal stasis and gastrointestinal obstruction. SMA syndrome may rarely combine with Nutcracker syndrome when left renal vein (LRV) was compressed between SMA and AA.Case presentationA 32-year-old female patient presented with complaints of gradually severe bloating, epigastric pain, left flank ache, nausea and occasional vomiting of 1 month’s duration. The epigastric and left flank ache was aggravated when the patient was supine and relieved in a prone or left lateral decubitus. The abdominal bloating was associated with early satiety. The vomiting always started 40 min after meal. The patient gave a history of urine stone with drotaverine hydrochloride tablets treatment for two weeks before the gastrointestinal symptoms arising. The patient had no significant surgical history, but had a rapid weight loss of approximately 10 kg with a body mass index (BMI) from 21 kg/m2 to less than 18 kg/m2 over the last two months. An abdominal examination revealed upper abdominal tenderness and distention. The urine routine examination showed no significant abnormality. The findings of initial blood tests and other laboratory investigations were unremarkable.ConclusionsThis case reports a female patient with SMA syndrome with Nutcracker syndrome predisposed by Antispasmodics. We highlight the importance of the combination therapy of long-term nutritional supporting and prokinetic agents. Rehabilitating practice after discharge is beneficial to reduce recurrence.

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Section: Discussionmentioning

confidence: 99%

Superior mesenteric artery syndrome coexists with Nutcracker syndrome in a female: a case report

Shi

et al. 2019

BMC Gastroenterol

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“…In conclusion, 11 provided records included in the revision [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. Diagram 1 presents the flow chart of the selection process, adapted from PRISMA guidelines ( Figure 4 ).…”

Section: Resultsmentioning

confidence: 99%

“…The most reported complication (4/12 cases) was acute gastric dilation; one patient reported Nutcracker syndrome and one patient developed pancreatitis [ 5 , 6 , 12 , 13 ].…”

Section: Resultsmentioning

confidence: 99%

Superior Mesenteric Artery Syndrome in Anorexia Nervosa: A Case Report and a Systematic Revision of the Literature

Bozzola,

Irrera,

Cirillo

et al. 2024

Nutrients

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Background. Superior mesenteric artery syndrome (SMAS) is a rare condition caused by the compression of the duodenum, which may occur in the case of fast weight loss. Currently, the relationship between superior mesenteric artery syndrome and anorexia nervosa is still unclear. The aim of this study is to identify the precocious clinical signs and symptoms of SMAS in patients affected by anorexia nervosa so as not to delay the diagnosis. Methods. We present the clinical case of a young female patient with anorexia nervosa complicated by SMAS. We performed a literature review of SMAS in children affected by anorexia nervosa between 1962 and 2023, according to the PRISMA Extension Guide for Scoping Reviews. Results. Reviewing the literature, 11 clinical cases were described for the pediatric age. The median age at diagnosis was 17 years (ranging from 13 to 18 years). The diagnosis of SMAS may be challenging as symptoms overlap those of anorexia, but it should be kept in mind mostly in cases of post-prandial abdominal pain, anxiety or depression, nausea, vomiting, and weight loss. Conclusion. Even specific clinical symptoms may act as flag tags to drive attention to this rare but potentially fatal condition.

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“…В большинстве случаев синдрома верхней брыжеечной артерии оперативное лечение не проводят, однако при рецидивирующем течении, отсутствии положительной динамики от консервативной терапии в течение 4-6 нед., риске кровотечения и перфорации кишечника необходимо рассмотреть вопрос о хирургической коррекции данного состояния [14].…”

Section: Discussionunclassified

Superior mesenteric artery syndrome following spinal deformity correction

Strelnikova

Сергеевна²,

Kozyrev

et al. 2020

Pediatr Traum Orthop Reconstr Surg

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Background. Superior mesenteric artery syndrome is a rare pathological condition caused by an abnormal transposition of the superior mesenteric artery from the abdominal part of the aorta. It results in compression of the distal part of the duodenum between the aorta and the superior mesenteric artery. It is clinically manifested by signs of acute intestinal obstruction, including pain in the epigastric region, nausea, and profuse vomiting. In the absence of timely treatment, patients may experience electrolyte disturbance, severe nutritional deficiency, the risk of perforation of the stomach, aspiration pneumonia, bezoar formation, thromboembolism, and the development of other life-threatening complications that can lead to death. Case study. In the presented case study, superior mesenteric artery syndrome developed in a 17-year-old girl after surgical correction of a spinal deformity in the treatment of idiopathic scoliosis. This was due to postoperative loss of body weight, as well as a rapid change in the patients ratio of growth to body weight. Discussion. Significant clinical improvement was achieved as a result of an integrated approach to the treatment of this complication. However, despite the successful result from conservative therapy, the patient remains at risk of developing chronic duodenal obstruction of varying severity, which may require surgical treatment. Conclusion. With the untimely and incomplete treatment of superior mesenteric artery syndrome, the risk of developing chronic intestinal obstruction increases. Treatment of this complication begins with conservative therapy. In the absence of the effect of conservative therapy, and in the case of disease progression, the development of life-threatening conditions (such as bleeding and perforation) requires surgical treatment.

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The Two Sides of Superior Mesenteric Artery Compression Treatment: Conservative or Surgical Management?

Cited by 11 publications

References 4 publications

Superior mesenteric artery syndrome coexists with Nutcracker syndrome in a female: a case report

Superior mesenteric artery syndrome coexists with Nutcracker syndrome in a female: a case report

Superior Mesenteric Artery Syndrome in Anorexia Nervosa: A Case Report and a Systematic Revision of the Literature

Superior mesenteric artery syndrome following spinal deformity correction

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