Superior Mesenteric Artery Syndrome: Where Do We Stand Today?
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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.
- yon Rokitanski C. Lehrbuch der Pathologischen Anatomie. Braumttller & Seidel, Vienna, 1861, p 187.
- Wilkie DPD. Chronic duodenal ileus. Am J Med Sci. 1927;173:643–9. CrossRef
- Welsch T, Buchler MW, Kienle P. Recalling superior mesenteric artery syndrome. Dig Surg. 2007;24:149–56. CrossRef
- Gustafsson L, Falk A, Lukes PJ, Gamklou R. Diagnosis and treatment of superior mesenteric artery syndrome. Br J Surg. 1984;71:499–501. CrossRef
- Konen E, Amitai M, Apter S, Garniek A, Gayer G, Nass S, Itzchak Y. CT angiography of superior mesenteric artery syndrome. AJR Am J Roentgenol. 1998;171:1279–81.
- Merrett ND, Wilson RB, Cosman P, Biankin AV. Superior mesenteric artery syndrome: diagnosis and treatment strategies. J Gastrointest Surg. 2009;13:287–92. CrossRef
- WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363:157–63. CrossRef
- http://apps.who.int/classifications/icd10/browse/2010/en. Accessed March 28, 2012.
- Ylinen P, Kinnunen J, Hockerstedt K. Superior mesenteric artery syndrome. A follow-up study of 16 operated patients. J Clin Gastroenterol. 1989;11:386–91. CrossRef
- Biank V, Werlin S. Superior mesenteric artery syndrome in children: a 20-year experience. J Pediatr Gastroenterol Nutr. 2006;42:522–5. CrossRef
- Laffont I, Bensmail D, Rech C, Prigent G, Loubert G, Dizien O. Late superior mesenteric artery syndrome in paraplegia: case report and review. Spinal Cord. 2002;40:88–91. CrossRef
- Lippl F, Hannig C, Weiss W, Allescher HD, Classen M, Kurjak M. Superior mesenteric artery syndrome: diagnosis and treatment from the gastroenterologist's view. J Gastroenterol. 2002;37:640–3. CrossRef
- Cho KR, Jo WM. Superior mesenteric artery syndrome after esophagectomy with cervical esophagogastrostomy. Ann Thorac Surg. 2006;82:e37-8. CrossRef
- Iwaoka Y, Yamada M, Takehira Y, Hanajima K, Nakamura T, Murohisa G, Hirai R, Kitagawa M. Superior mesenteric artery syndrome in identical twin brothers. Intern Med. 2001;40:713–5. CrossRef
- Caspi B, Deutsch H, Grunshpan M, Flidel O, Hagay Z, Appelman Z. Prenatal manifestation of superior mesenteric artery syndrome. Prenat Diagn. 2003;23:932–4. CrossRef
- Goin LS, Wilk SP. Intermittent arteriomesenteric occlusion of the duodenum. Radiology. 1956;67:729–37.
- Unal B, Aktas A, Kemal G, Bilgili Y, Guliter S, Daphan C, Aydinuraz K. Superior mesenteric artery syndrome: CT and ultrasonography findings. Diagn Interv Radiol. 2005;11:90–5.
- Froese AP, Szmuilowicz J, Bailey JD. The superior-mesenteric-artery syndrome: cause or complication of anorexia nervosa? Can Psychiatr Assoc J. 1978;23:325–7.
- Lee CW, Park MI, Park SJ, Moon W, Kim HH, Kim BJ, Shim IK, Park SS. [A case of superior mesenteric artery syndrome caused by anorexia nervosa]. Korean J Gastroenterol. 2011;58:280–3. CrossRef
- Jordaan GP, Muller A, Greeff M, Stein DJ. Eating disorder and superior mesenteric artery syndrome. J Am Acad Child Adolesc Psychiatry. 2000;39:1211. CrossRef
- Elbadaway MH. Chronic superior mesenteric artery syndrome in anorexia nervosa. Br J Psychiatry. 1992;160:552–4. CrossRef
- Okugawa Y, Inoue M, Uchida K, Kawamoto A, Koike Y, Yasuda H, Otake K, Miki C, Kusunoki M. Superior mesenteric artery syndrome in an infant: case report and literature review. J Pediatr Surg. 2007;42:E5-8. CrossRef
- Lee S-B, Kang H-C, Yoon Y-J. A case report of superior mesenteric artery syndrome after acute gastroenteritis. Korean J Fam Med. 2010;31:862–6. CrossRef
- Burrington JD. Superior mesenteric artery syndrome in children. Am J Dis Child. 1976;130:1367–70.
- Altiok H, Lubicky JP, DeWald CJ, Herman JE. The superior mesenteric artery syndrome in patients with spinal deformity. Spine (Phila Pa 1976). 2005;30:2164–70. CrossRef
- Lee CS, Mangla JC. Superior mesenteric artery compression syndrome. Am J Gastroenterol. 1978;70:141–50.
- Richardson WS, Surowiec WJ. Laparoscopic repair of superior mesenteric artery syndrome. Am J Surg. 2001;181:377–8. CrossRef
- Morris TC, Devitt PG, Thompson SK. Laparoscopic duodenojejunostomy for superior mesenteric artery syndrome—how I do it. J Gastrointest Surg. 2009;13:1870–3. CrossRef
- Kim IY, Cho NC, Kim DS, Rhoe BS. Laparoscopic duodenojejunostomy for management of superior mesenteric artery syndrome: two cases report and a review of the literature. Yonsei Med J. 2003;44:526–9.
- Superior Mesenteric Artery Syndrome: Where Do We Stand Today?
Journal of Gastrointestinal Surgery
Volume 16, Issue 12 , pp 2203-2211
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- 1. Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University Hospital, Seoul, South Korea
- 8. Institute for Digestive Research, Soonchunhyang University College of Medicine, Daesagwan-gil 22, Yongsan-gu, Seoul, South Korea
- 2. Department of Internal Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul, South Korea
- 3. Department of Internal Medicine, Keimyung University College of Medicine, Daegu, South Korea
- 4. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
- 5. Department of Internal Medicine, Digestive Disease Research Institute, Sanbon Hospital, Wonkwang University School of Medicine, Gyeonggi, South Korea
- 6. Department of Internal Medicine, College of Medicine, Kyunghee University, Seoul, South Korea
- 7. Department of Internal Medicine, Konyang University College of Medicine, Daejeon, South Korea