Abstract
Superior mesenteric artery syndrome is a rare but well-known clinical entity characterized by compression of the third or transverse portion of the duodenum against the aorta by the superior mesenteric artery, resulting in chronic, intermittent, or acute, complete or partial, duodenal obstruction. The treatment for this arteriomesenteric compression includes conservative measures and surgical intervention. The aim of the study was to evaluate our surgical management and outcomes of the patients with superior mesenteric artery syndrome. The cases with superior mesenteric artery syndrome admitted between January 2000 and January 2010 were retrospectively investigated from the patients’ records. All six patients had a history of chronic abdominal pain, nausea, postprandial early satiety, vomiting, and weight loss. Diagnostic methods included barium esophagogastroduodenography, upper gastrointestinal endoscopy, and computed tomography. Medical management was the first step of treatment in all cases before surgery. Of those, four underwent Roux-en-Y duodenojejunostomy and two underwent gastroenterostomy. Postoperative periods were uneventful and mean duration of hospitalization after the operations was 7 days. Conservative initial treatment is usually followed by surgical intervention for the main problem that is the narrowing of the aortomesenteric angle in patients with superior mesenteric artery syndrome. This syndrome should be considered in the differential diagnosis in patients with chronic upper abdominal pain. Duodenojejunostomy is the most frequently used procedure with a high success rate.
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Welsch T, Büchler MW, Kienle P (2007) Recalling superior mesenteric artery syndrome. Dig Surg 24:149–156
Neri S, Signorelli SS, Mondati E, Pulvirenti D, Campanile E, Di Pino L et al (2005) Ultrasound imaging in diagnosis of superior mesenteric artery syndrome. J Intern Med 257:346–351
Agrawal GA, Johnson PT, Fishman EK (2007) Multidetector row CT of superior mesenteric artery syndrome. J Clin Gastroenterol 41:62–65
Ylinen P, Kinnunen J, Hockerstedt K (1989) Superior mesenteric artery syndrome. A follow-up study of 16 operated patients. J Clin Gastroenterol 11:386–391
Wilkie DP (1927) Chronic duodenal ileus. Am J Med Sci 173:643–649
Merrett ND, Wilson RB, Cosman P, Biankin AV (2009) Superior mesenteric artery syndrome: diagnosis and treatment strategies. J Gastrointest Surg 13:287–292
Lippl F, Hannig C, Weiss W, Allesher HD, Classen M, Kurjak M (2002) Superior mesenteric artery syndrome: diagnosis and treatment from the gastroenterologist’s view. J Gastroenterol 37:640–643
Reckler JM, Bruck HM, Munster AM, Curreri PW, Pruitt BA Jr (1972) Superior mesenteric artery syndrome as a consequence of burn injury. J Trauma 12:979–985
Smith BM, Zyromski NJ, Purtill MA (2008) Superior mesenteric artery syndrome: an under recognized entity in the trauma population. J Trauma 64:827–830
Cohen LB, Field SP, Sachar DB (1985) The superior mesenteric artery syndrome. The disease that isn’t, or is it. J Clin Gastroenterol 7:113–116
Lim JE, Duke GL, Eachempati SR (2003) Superior mesenteric artery syndrome presenting with acute massive gastric dilatation, gastric wall pneumatosis, and portal venous gas. Surgery 134:840–843
Hines JR, Gore RM, Ballantyne GH (1984) Superior mesenteric artery syndrome. Diagnostic criteria and therapeutic approaches. Am J Surg 148:630–632
Baltazar U, Dunn J, Floresguerra C, Schmidt L, Browder W (2000) Superior mesenteric artery syndrome: an uncommon cause of intestinal obstruction. South Med J 93:606–608
Gersin KS, Heniford BT (1998) Laparoscopic duodenojejunostomy for treatment of superior mesenteric artery syndrome. JSLS 2:281–284
Lee CS, Mangla JC (1978) Superior mesenteric artery compression syndrome. Am J Gastroenterol 70:141–150
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Yakan, S., Calıskan, C., Kaplan, H. et al. Superior Mesenteric Artery Syndrome: A Rare Cause of Intestinal Obstruction. Diagnosis and Surgical Management. Indian J Surg 75, 106–110 (2013). https://doi.org/10.1007/s12262-012-0423-x
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DOI: https://doi.org/10.1007/s12262-012-0423-x