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Superior Mesenteric Artery Syndrome
Aka: Superior Mesenteric Artery Syndrome, Cast Syndrome, Wilkie Syndrome, Mesenteric Duodenal Compression Syndrome, Duodenal Occlusion by Superior Mesenteric Artery
- Pathophysiology
- Third section of Duodenum constricted between superior Mesenteric Artery and abdominal aorta
- Epidemiology
- Rare
- Risk Factors
- Genetic predisposition (more common in the twin of an affected patient)
- Corrective spinal surgery for Scoliosis
- Slender patients with acute weight loss (loss of mesenteric fat pad)
- Anorexia Nervosa
- Gastroenteritis
- Findings: Proximal Small Bowel Obstruction
- Bilious Emesis
- Upper Abdominal Pain
- Early satiety
- Weight loss
- Associated Conditions
- Celiac Axis Compression Syndrome.
- Imaging
- XRay Abdomen
- CT Abdomen and Pelvis
- Abdominal Ultrasound
- Complications
- Small Bowel Obstruction related complications
- Gastric or Intestinal Pneumatosis
- Intestinal Perforation
- Duodenal Bezoar
- Portal Vein Gas
- Malnutrition and Electrolyte disturbance
- Aspiration Pneumonia
- Management
- Manage Small Bowel Obstruction
- Supportive care (hydration, Electrolyte replacement)
- Treat underlying causes
- Surgical interventions
- Duodenum repositioning to right of SMA (Strong’s procedure)
- Gastrojejunostomy (duodenal resection)
- Duodenojejunostomy
- Resources
- Superior Mesenteric Artery Syndrome (NIH Rare Diseases)
- https://rarediseases.info.nih.gov/diseases/7712/superior-mesenteric-artery-syndrome