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Superior Mesenteric Artery Syndrome: Where Do We Stand Today?

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

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References

  1. yon Rokitanski C. Lehrbuch der Pathologischen Anatomie. Braumttller & Seidel, Vienna, 1861, p 187.

  2. Wilkie DPD. Chronic duodenal ileus. Am J Med Sci. 1927;173:643–9.

    Article  Google Scholar 

  3. Welsch T, Buchler MW, Kienle P. Recalling superior mesenteric artery syndrome. Dig Surg. 2007;24:149–56.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  5. 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.

    PubMed  CAS  Google Scholar 

  6. Merrett ND, Wilson RB, Cosman P, Biankin AV. Superior mesenteric artery syndrome: diagnosis and treatment strategies. J Gastrointest Surg. 2009;13:287–92.

    Article  PubMed  CAS  Google Scholar 

  7. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363:157–63.

    Article  Google Scholar 

  8. http://apps.who.int/classifications/icd10/browse/2010/en. Accessed March 28, 2012.

  9. 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.

    Article  PubMed  CAS  Google Scholar 

  10. Biank V, Werlin S. Superior mesenteric artery syndrome in children: a 20-year experience. J Pediatr Gastroenterol Nutr. 2006;42:522–5.

    Article  PubMed  Google Scholar 

  11. 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.

    Article  PubMed  CAS  Google Scholar 

  12. 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.

    Article  PubMed  Google Scholar 

  13. Cho KR, Jo WM. Superior mesenteric artery syndrome after esophagectomy with cervical esophagogastrostomy. Ann Thorac Surg. 2006;82:e37-8.

    Article  PubMed  Google Scholar 

  14. 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.

    Article  PubMed  CAS  Google Scholar 

  15. 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.

    Article  PubMed  CAS  Google Scholar 

  16. Goin LS, Wilk SP. Intermittent arteriomesenteric occlusion of the duodenum. Radiology. 1956;67:729–37.

    PubMed  CAS  Google Scholar 

  17. 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.

    PubMed  Google Scholar 

  18. 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.

    PubMed  CAS  Google Scholar 

  19. 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.

    Article  PubMed  Google Scholar 

  20. Jordaan GP, Muller A, Greeff M, Stein DJ. Eating disorder and superior mesenteric artery syndrome. J Am Acad Child Adolesc Psychiatry. 2000;39:1211.

    Article  PubMed  CAS  Google Scholar 

  21. Elbadaway MH. Chronic superior mesenteric artery syndrome in anorexia nervosa. Br J Psychiatry. 1992;160:552–4.

    Article  PubMed  CAS  Google Scholar 

  22. 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.

    Article  PubMed  Google Scholar 

  23. 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.

    Article  Google Scholar 

  24. Burrington JD. Superior mesenteric artery syndrome in children. Am J Dis Child. 1976;130:1367–70.

    PubMed  CAS  Google Scholar 

  25. 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.

    Article  Google Scholar 

  26. Lee CS, Mangla JC. Superior mesenteric artery compression syndrome. Am J Gastroenterol. 1978;70:141–50.

    PubMed  CAS  Google Scholar 

  27. Richardson WS, Surowiec WJ. Laparoscopic repair of superior mesenteric artery syndrome. Am J Surg. 2001;181:377–8.

    Article  PubMed  CAS  Google Scholar 

  28. Morris TC, Devitt PG, Thompson SK. Laparoscopic duodenojejunostomy for superior mesenteric artery syndrome—how I do it. J Gastrointest Surg. 2009;13:1870–3.

    Article  PubMed  Google Scholar 

  29. 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.

    PubMed  Google Scholar 

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Acknowledgments

This study was supported by a grant of the Korean Society of Neurogastroenterology and Motility.

Conflict of Interest

No conflict of interest exists.

Author information

Authors and Affiliations

  1. Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University Hospital, Seoul, South Korea

    Tae Hee Lee & Joon Seong Lee

  2. Department of Internal Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul, South Korea

    Yunju Jo

  3. Department of Internal Medicine, Keimyung University College of Medicine, Daegu, South Korea

    Kyung Sik Park

  4. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea

    Jae Hee Cheon

  5. Department of Internal Medicine, Digestive Disease Research Institute, Sanbon Hospital, Wonkwang University School of Medicine, Gyeonggi, South Korea

    Yong Sung Kim

  6. Department of Internal Medicine, College of Medicine, Kyunghee University, Seoul, South Korea

    Jae Young Jang

  7. Department of Internal Medicine, Konyang University College of Medicine, Daejeon, South Korea

    Young Woo Kang

  8. Institute for Digestive Research, Soonchunhyang University College of Medicine, Daesagwan-gil 22, Yongsan-gu, Seoul, South Korea

    Joon Seong Lee

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  1. Tae Hee Lee
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Correspondence to Joon Seong Lee.

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Lee, T.H., Lee, J.S., Jo, Y. et al. Superior Mesenteric Artery Syndrome: Where Do We Stand Today?. J Gastrointest Surg 16, 2203–2211 (2012). https://doi.org/10.1007/s11605-012-2049-5

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  • DOI: https://doi.org/10.1007/s11605-012-2049-5

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