Wilkie’s syndrome: a case report of favourable minimally invasive surgery

Santos, Sara Catarino; Loureiro, Ana Rita; Simão, Rosa; Pereira, Jorge; Pinheiro, Luís Filipe; Casimiro, Carlos

doi:10.1093/jscr/rjy027

Cited by 8 publications

(9 citation statements)

References 7 publications

(33 reference statements)

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“…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 [5]. The symptoms of SMA syndrome include acute or chronic episodic epigastric ache, bloating or vomiting, which associated with rapid growth in children and rapid weight loss in adults, particularly in young women [6, 7]. Once the compression of left renal vein (LRV) was just happened by SMA and AA, the SMA syndrome may rarely combine with Nutcracker phenomenon [8].…”

Section: Introductionmentioning

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: Introductionmentioning

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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“…Failure of conservative management as in our patient warrants surgical management. Duodenojejunostomy is the procedure of choice [6]. Other options include gastrojejunostomy as performed in our patient.…”

Section: Discussionmentioning

confidence: 99%

Cast syndrome

Badireddy

Govardhan

Krishna

2019

Oxford Medical Case Reports

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Cast syndrome, commonly known as superior mesenteric artery (SMA) syndrome is a rare cause of small bowel obstruction caused by compression of third part of duodenum from narrowing of the angle between superior mesenteric artery and abdominal aorta resulting in symptoms of duodenal outflow obstruction. A 46-year-old male presented with acute worsening of chronic abdominal pain, nausea and vomiting aggravated with eating. Computed tomography of abdomen and pelvis revealed the dilatation of gastric and proximal duodenum due to compression of third part of duodenum between superior mesenteric artery and aorta. Conservative management with total parental nutrition failed and patient underwent gastrojejunostomy with relief of his symptoms. Cast syndrome is a rare condition but should be kept in mind in patients with abdominal pain, vomiting, early satiety and weight loss. CT abdomen usually reveals the diagnosis but upper GI endoscopy helps to rule out other causes of duodenal obstruction and gastric dilatation.

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“…Von Rokitansky describió el SAMS por primera vez en 1861, pero no fue sino hasta la década de 1920 que Wilkie caracterizó en términos fisiopatológicos la enfermedad que luego adoptó su nombre 2,6,8,12,13 . En la mayoría de los casos, la tercera porción del duodeno pasa a través de un ángulo formado por la aorta abdominal y la arteria mesentérica superior a nivel de la segunda vértebra lumbar.…”

Section: Discussionunclassified

“…El síndrome de Wilkie, o síndrome de arteria mesentérica superior (SAMS), es un padecimiento infrecuente que provoca obstrucción intestinal crónica; es efecto de una compresión mecánica de la tercera porción del duodeno de manera extrínseca, debido a una disminución del ángulo entre la arteria mesentérica superior y la aorta menor de 20 a 25° (de acuerdo con los estudios consultados) [1][2][3][4][5][6] .…”

Section: Introductionunclassified

“…Esta afección tiene una incidencia notificada en la bibliografía médica mundial de 0.012 a 2.4%, es más frecuente en adultos jóvenes de sexo femenino, y puede llevar a una elevada morbimortalidad [1][2][3][7][8][9][10][11] . En 1998, Gersin y Heniford publicaron el primer caso de un paciente con SAMS programado para duodenoyeyunostomía laparoscópica de mínima invasión con resultados favorables.…”

Section: Introductionunclassified

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Manejo laparoscópico para el síndrome de Wilkie

Martínez¹,

Martínez²,

Sánchez-Ussa³

et al. 2019

CIRU

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Introducción: El síndrome de Wilkie es una entidad poco frecuente que se presenta como una obstrucción intestinal crónica secundaria a la compresión mecánica de la tercera porción del duodeno; la compresión es extrínseca por una disminución del ángulo entre la arteria mesentérica superior y la aorta. Esta anomalía tiene una incidencia informada en la bibliografía médica mundial de 0.012 a 2.4% y puede propiciar una elevada morbimortalidad; de forma adicional, existen grandes controversias en relación con su diagnóstico y tratamiento, por lo cual los autores presentan un informe de caso de un paciente con diagnóstico de síndrome de Wilkie y su manejo quirúrgico por vía laparoscópica. Métodos: Se presenta un caso de un paciente con diagnóstico clínico e imagenológico de síndrome de arteria mesentérica superior y se realiza un revisión crítica de las publicaciones, con atención a los artículos publicados en las bases de datos de PubMed y ScienceDirect en los últimos ocho años sobre el síndrome de Wilkie y se completa la revisión con artículos clásicos sobre el tema. Caso: Paciente de 27 años con 20 años de dolor abdominal agudizado una semana antes del ingreso, con diagnóstico clínico e imagenológico de síndrome de Wilkie. El enfermo muestra resistencia al tratamiento médico, por lo que se practicó una duodenoyeyunostomía laparoscópica sin complicaciones perioperatorias y con resultados satisfactorios. Discusión y conclusiones: El síndrome de arteria mesentérica superior es un trastorno raro que exige medidas quirúrgicas en algunos escenarios. La duodenoyeyunostomía laparoscópica es el procedimiento de elección para tratar esta entidad, como se evidenció en este caso, lo cual concuerda con lo publicado en la bibliografía médica mundial.

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Wilkie’s syndrome: a case report of favourable minimally invasive surgery

Cited by 8 publications

References 7 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

Cast syndrome

Manejo laparoscópico para el síndrome de Wilkie

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