Original Article

Journal of Gastrointestinal Surgery

, Volume 16, Issue 12, pp 2203-2211

First online:

Superior Mesenteric Artery Syndrome: Where Do We Stand Today?

  • Tae Hee LeeAffiliated withInstitute for Digestive Research, Digestive Disease Center, Soonchunhyang University Hospital
  • , Joon Seong LeeAffiliated withInstitute for Digestive Research, Digestive Disease Center, Soonchunhyang University HospitalInstitute for Digestive Research, Soonchunhyang University College of Medicine Email author 
  • , Yunju JoAffiliated withDepartment of Internal Medicine, Eulji General Hospital, Eulji University College of Medicine
  • , Kyung Sik ParkAffiliated withDepartment of Internal Medicine, Keimyung University College of Medicine
  • , Jae Hee CheonAffiliated withDepartment of Internal Medicine, Yonsei University College of Medicine
  • , Yong Sung KimAffiliated withDepartment of Internal Medicine, Digestive Disease Research Institute, Sanbon Hospital, Wonkwang University School of Medicine
  • , Jae Young JangAffiliated withDepartment of Internal Medicine, College of Medicine, Kyunghee University
  • , Young Woo KangAffiliated withDepartment of Internal Medicine, Konyang University College of Medicine

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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.


Diagnosis Management Superior mesenteric artery syndrome