Journal of Gastrointestinal Surgery

, Volume 16, Issue 12, pp 2203–2211

Superior Mesenteric Artery Syndrome: Where Do We Stand Today?


  • Tae Hee Lee
    • Institute for Digestive Research, Digestive Disease CenterSoonchunhyang University Hospital
    • Institute for Digestive Research, Digestive Disease CenterSoonchunhyang University Hospital
    • Institute for Digestive ResearchSoonchunhyang University College of Medicine
  • Yunju Jo
    • Department of Internal Medicine, Eulji General HospitalEulji University College of Medicine
  • Kyung Sik Park
    • Department of Internal MedicineKeimyung University College of Medicine
  • Jae Hee Cheon
    • Department of Internal MedicineYonsei University College of Medicine
  • Yong Sung Kim
    • Department of Internal Medicine, Digestive Disease Research Institute, Sanbon HospitalWonkwang University School of Medicine
  • Jae Young Jang
    • Department of Internal Medicine, College of MedicineKyunghee University
  • Young Woo Kang
    • Department of Internal MedicineKonyang University College of Medicine
Original Article

DOI: 10.1007/s11605-012-2049-5

Cite this article as:
Lee, T.H., Lee, J.S., Jo, Y. et al. J Gastrointest Surg (2012) 16: 2203. doi:10.1007/s11605-012-2049-5



Most data on large studies of superior mesenteric artery syndrome (SMAS) were published over 30 years ago. New studies are needed so that current medical progress can influence SMAS diagnosis and improve therapeutic outcomes.


This study was conducted to report the clinical features and outcomes of SMAS. From January 2000 to December 2009, 80 cases (53 females, median age 28 years) of SMAS were collected retrospectively from seven university hospitals in South Korea.


The median body mass index at diagnosis was 17.4 kg/m2, with a range of 10–22.1. Forty (50 %) of the 80 SMAS patients had co-morbid conditions including mental and behavioral disorders, infectious disorders, and disorders of the nervous system (21.3, 12.5, and 11.3 %, respectively). Computerized tomography was most commonly (93.8 %) used to diagnose SMAS. The overall medical management success and recurrence rates were 71.3 and 15.8 %, respectively. Surgical management had a high 92.9 % (13/14) success rate. The most common surgical procedure for SMAS was laparoscopic duodenojejunostomy.


This is the largest case series to document the clinical features and changes in diagnostic modalities, medical and surgical managements, and their outcomes in SMAS patients. Laparoscopic duodenojejunostomy is the preferred surgical procedure when medical management of the disease fails.


DiagnosisManagementSuperior mesenteric artery syndrome

Copyright information

© The Society for Surgery of the Alimentary Tract 2012