Vascular compression of the duodenum

Mansberger, Arlie R.; Hearn, John B.; Byers, Robert M.; Fleisig, Norbert; Buxton, Robert W.

doi:10.1016/0002-9610(68)90134-7

Cited by 84 publications

(17 citation statements)

References 15 publications

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“…Upper gastrointestinal series, computed tomography (CT) scan or CT angiography, magnetic resonance (MR) angiography, conventional angiography, ultrasonography and endoscopy have all been used for diagnosis [21, 23, 26, 47, 54, 58, 59]. Conventional barium studies still play an important role for diagnosis and the classic but unspecific picture is that of a dilated proximal duodenum with an abrupt termination of the barium column in the third portion.…”

Section: Diagnosismentioning

confidence: 99%

“…It has been correlated with an earlier postoperative recovery [22, 63]. The disadvantages are that the procedure can be aggravated or impossible due to adhesions and that caudal displacement of the duodenum cannot always be achieved because of interference with short vessels from the inferior pancreaticoduodenal artery to the duodenum [6, 21]. …”

Section: Treatment and Outcomementioning

confidence: 99%

“…In parallel to compression of the duodenum, compression of the left renal vein in the aortomesenteric angle associated with venous hypertension is known as the ‘nutcracker syndrome’ [19]. The mean angle formed by the superior mesenteric artery and the aorta varies between 38 and 56° but angles ranged from 20 to 70° in an analysis of 64 human aortas [20,21,22]. The mean radiographic aortomesenteric distance was 10–28 mm [23].…”

Section: Anatomy and Etiologymentioning

confidence: 99%

“…Acute superior mesenteric artery syndrome with a history of a month and less seem to be more apt to conservative treatment [21, 30]. Medical treatment pursues correction of the fluid and electrolyte balance, a positive nitrogen balance and an increase in body weight promoting restoration of the retroperitoneal fat tissue with consecutive increase of the aortomesenteric angle.…”

Section: Treatment and Outcomementioning

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: Diagnosismentioning

confidence: 99%

Section: Treatment and Outcomementioning

confidence: 99%

Section: Anatomy and Etiologymentioning

confidence: 99%

Section: Treatment and Outcomementioning

confidence: 99%

See 2 more Smart Citations

Recalling Superior Mesenteric Artery Syndrome

Welsch

Büchler²,

Kienle³

2007

Dig Surg

340

474

View full text Add to dashboard Cite

show abstract

“…Several factors are involved in the pathogenesis, but abnormal duodenal fixity in the pres ence of a narrow aorto-mesenteric angle appears to be critical [1,2], Clinical presentation may be chronic or acute and is due to duodenal obstruction. Diagnosis is usually achieved by conventional gastrointestinal (GI) barium or hypotonic duodenography, endoscopy and selective angiography.…”

mentioning

confidence: 99%