Case Report of Novel Endoscopic Findings in SMA Syndrome Demonstrated by Video Endoscopy: Visibly Pulsating, Band-Like, Compression in Third Portion of Duodenum, with the Pulsations Corresponding One-for-One with the Radial Pulse and EKG Cycle

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References

  1. 1.

    Neri S, Signorelli SS, Mondati E, et al. Ultrasound imaging in diagnosis of superior mesenteric artery syndrome. J Intern Med. 2005;257:346–351.

    Article  CAS  PubMed  Google Scholar 

  2. 2.

    Unal B, Aktaş A, Kemal G, et al. Superior mesenteric artery syndrome: CT and ultrasonography findings. Diagn Interv Radiol. 2005;11:90–95.

    PubMed  Google Scholar 

  3. 3.

    Sellers E, Clayton S, Quintero E, Pinkas H. Superior mesenteric artery syndrome in a young woman. Patient Care published Mar 25, 2015. http://www.patientcareonline.com/gastrointestinal-disorders/superior-mesenteric-artery-syndrome-young-woman. Accessed October 11, 2018.

  4. 4.

    Ozkurt H, Cenker MM, Bas N, Erturk SM, Basak M. Measurement of the distance and angle between the aorta and superior mesenteric artery: normal values in different BMI categories. Surg Radiol Anat. 2007;29:595–599.

    Article  PubMed  Google Scholar 

  5. 5.

    Sapkas G, O’Brien JP. Vascular compression of the duodenum (cast syndrome) associated with the treatment of spinal deformities. A report of six cases. Arch Orthop Trauma Surg. 1981;98:7–11.

    Article  CAS  PubMed  Google Scholar 

  6. 6.

    Gustafsson L, Falk A, Lukes PJ, Gamklou R. Diagnosis and treatment of superior mesenteric artery syndrome. Br J Surg. 1984;71:499–501.

    Article  CAS  PubMed  Google Scholar 

  7. 7.

    Rabie ME, Ogunbiyi O, Al Qahtani AS, Taha S, El Hadad A, El Hakeem I. Superior mesenteric artery syndrome: clinical and radiological considerations. Surg Res Pract. 2015;2015:628705. https://doi.org/10.1155/2015/628705.

    Article  PubMed  PubMed Central  Google Scholar 

  8. 8.

    Kirby GC, Faulconer ER, Robinson SJ, Perry A, Downing R. Superior mesenteric artery syndrome: a single centre experience of laparoscopic duodenojejunostomy as the operation of choice. Ann R Coll Surg Engl. 2017;99:472–475. https://doi.org/10.1308/rcsann.2017.0063.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. 9.

    Booka E, Kawakubo H, Ishii K, et al. Superior mesenteric artery syndrome caused by massive lumbar osteophytes: a case report. Spine. 2015;40:E909–E912.

    Article  PubMed  Google Scholar 

  10. 10.

    Salem A, Al Ozaibi L, Nassif SMM, Osman RAGS, Al Abed NM, Badri FM. Superior mesenteric artery syndrome: a diagnosis to be kept in mind (case report and literature review). Int J Surg Case Rep. 2017;34:84–86. https://doi.org/10.1016/j.ijscr.2017.03.018.

    Article  PubMed  PubMed Central  Google Scholar 

  11. 11.

    Yan C, Hu ZW, Wu JM, Zhang C, Yan L, Wang ZG. Laparoscopic Toupet fundoplication with duodenojejunostomy for the management of superior mesenteric artery syndrome with reflux symptoms. Medicine (Baltimore). 2017;96:e5771. https://doi.org/10.1097/MD.0000000000005771.

    Article  Google Scholar 

  12. 12.

    Cappell MS. Endoscopic, radiographic and manometric findings associated with cardiovascular dysphagia. Dig Dis Sci. 1995;40:166–176.

    Article  CAS  PubMed  Google Scholar 

  13. 13.

    Cappell MS. Manometric findings in dysphagia secondary to left atrial dilatation: giant, cyclic midesophageal pressure waves occurring with every heart beat. Dig Dis Sci. 1991;36:693–698.

    Article  CAS  PubMed  Google Scholar 

  14. 14.

    Yao SY, Mikami R, Mikami S. Minimally invasive surgery for superior mesenteric artery syndrome: a case report. World J Gastroenterol. 2015;21:12970–12975. https://doi.org/10.3748/wjg.v21.i45.12970.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Dr. Cappell treated the patient and wrote the bulk of the paper. Drs. Mihajlo Gjeorgjievski and Molly Orosey also treated the patient and wrote part of the case report section.

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Correspondence to Mitchell S. Cappell.

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The authors declare that they have no conflict of interest. In particular, Dr. Cappell, as a consultant of the United States Food and Drug Administration (FDA) Advisory Committee for Gastroenterology Drugs, affirms that this paper does not discuss any proprietary confidential pharmaceutical data submitted to the FDA and reviewed by Dr. Cappell. Dr. Cappell is also a member of the speaker’s bureau for AstraZeneca and Daiichi Sankyo, co-marketers of Movantik. Dr. Cappell has had one-time consultancies for Mallinckrodt and Shire in the past. This work does not discuss any drug manufactured or marketed by AstraZeneca, Daiichi Sankyo, Shire, or Mallinckrodt.

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Video-endoscopy demonstrates that the cyclic narrowing is visibly pulsating; one-for-one with the palpated radial pulse; and one-for-one with the electrocardiographic cycle (with peak luminal narrowing occurring after the electrocardiographic QRS complex with a brief lag) (WMV 3216 kb)

Supplementary material 2 (DOCX 15 kb)

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Cappell, M.S., Gjeorgjievski, M. & Orosey, M. Case Report of Novel Endoscopic Findings in SMA Syndrome Demonstrated by Video Endoscopy: Visibly Pulsating, Band-Like, Compression in Third Portion of Duodenum, with the Pulsations Corresponding One-for-One with the Radial Pulse and EKG Cycle. Dig Dis Sci 64, 1715–1718 (2019). https://doi.org/10.1007/s10620-019-5472-6

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Keywords

  • Superior mesenteric artery (SMA) syndrome
  • Small bowel obstruction (SBO)
  • Duodenal obstruction
  • Vascular compression
  • Esophagogastroduodenoscopy
  • Endoscopic videography
  • Pulsatile compressions of duodenum