II. Pathophysiology

  1. Third section of Duodenum constricted between superior Mesenteric Artery and abdominal aorta

III. Epidemiology

  1. Rare

IV. Risk Factors

  1. Genetic predisposition (more common in the twin of an affected patient)
  2. Corrective spinal surgery for Scoliosis
  3. Slender patients with acute weight loss (loss of mesenteric fat pad)
    1. Anorexia Nervosa
    2. Gastroenteritis

V. Findings: Proximal Small Bowel Obstruction

  1. Bilious Emesis
  2. Upper Abdominal Pain
  3. Early satiety
  4. Weight loss

VI. Associated Conditions

  1. Celiac Axis Compression Syndrome.

VIII. Complications

  1. Small Bowel Obstruction related complications
    1. Gastric or Intestinal Pneumatosis
    2. Intestinal Perforation
    3. Duodenal Bezoar
    4. Portal Vein Gas
  2. Malnutrition and Electrolyte disturbance
  3. Aspiration Pneumonia

IX. Management

  1. Manage Small Bowel Obstruction
  2. Supportive care (hydration, Electrolyte replacement)
  3. Treat underlying causes
  4. Surgical interventions
    1. Duodenum repositioning to right of SMA (Strong’s procedure)
    2. Gastrojejunostomy (duodenal resection)
    3. Duodenojejunostomy

X. Resources

  1. Superior Mesenteric Artery Syndrome (NIH Rare Diseases)
    1. https://rarediseases.info.nih.gov/diseases/7712/superior-mesenteric-artery-syndrome

Images: Related links to external sites (from Bing)

Related Studies