scholarly journals Superior mesenteric artery syndrome masquerading as chronic gastric volvulus in a child with severe acute malnutrition: a case report

2020 ◽  
Vol 7 (8) ◽  
pp. 2758
Author(s):  
M. Mokarram Ali ◽  
Amit Kumar ◽  
Rashi . ◽  
Amit K. Sinha ◽  
Bindey Kumar
Keyword(s):  
Intestinal Obstruction ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Severe Acute Malnutrition ◽  
Gastric Volvulus ◽  
Acute Malnutrition ◽  
Severe Malnutrition ◽  
Sma Syndrome ◽  
Paediatric Age ◽  
High Index Of Suspicion

Superior mesenteric artery (SMA) syndrome is a rare cause of high intestinal obstruction. It is commonly seen in severely malnourished patients presenting with repeated episodes of vomiting. We report a case of SMA syndrome in a 3 years old male child provisionally diagnosed as chronic gastric volvulus with severe acute malnutrition. The diagnosis of SMA syndrome was confirmed on abdominal exploration. SMA syndrome is a rare case of intestinal obstruction in paediatric age group. Chronic malnutrition is one of the common causes of this entity. There should be a high index of suspicion for this syndrome when we encounter a child with severe malnutrition and recurrent vomiting.

Superior mesenteric artery (SMA) syndrome: an unusual cause of intestinal obstruction in palliative care

2017 ◽  
Vol 6 (1) ◽  
pp. 91-93 ◽  
Author(s):  
Chun-Yan So ◽  
Kwok-Ying Chan ◽  
Ho-Yan Au ◽  
Man-Lui Chan ◽  
Theresa Lai
Keyword(s):  
Palliative Care ◽  
Intestinal Obstruction ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Sma Syndrome

scholarly journals Facts and fantasies about superior mesenteric artery syndrome: an unusual cause of intestinal obstruction

2019 ◽  
Vol 6 (7) ◽  
pp. 2591
Author(s):  
Swapnil Singh Kushwaha ◽  
Shikha Goja
Keyword(s):  
Intestinal Obstruction ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Early Recognition ◽  
Recurrent Abdominal Pain ◽  
Favourable Outcome ◽  
Vascular Compression ◽  
Fatty Tissue ◽  
Diagnostic Dilemma ◽  
Sma Syndrome

Superior mesenteric artery (SMA) syndrome (also known as Wilkie’s syndrome) is an unusual cause of proximal intestinal obstruction, attributable to vascular compression of the third part of duodenum between the superior mesenteric artery and the abdominal aorta due to acute angulation of SMA. It is a life threatening disease as it poses a diagnostic dilemma and often diagnosed by exclusion of other causes. It is an acquired disorder and is commonly due to loss of fatty tissue as a result of a variety of debilitating conditions. We report a case of SMA syndrome in a 23 year young asthenic female patient, with a long history of recurrent abdominal pain, epigastric fullness, voluminous vomiting, and weight loss. Symptoms persisted for 1 year and the patient underwent extensive investigations, but to no avail. Thereafter she developed proximal intestinal obstruction, which unravelled her diagnosis. Abdominal examination revealed epigastric fullness, tenderness and hyper peristaltic bowel sounds. We performed small bowel enteroclysis, upper gastrointestinal series, abdominal computer-tomography (CT) and ultrasonography to establish the diagnosis. Conservative treatment was tried for one month but failed. There was no relief of symptoms in the left lateral decubitus or prone position. Finally, the patient successfully underwent Roux-en-Y duodenojejunal anastomosis with a postoperative favourable outcome. This case emphasizes the challenges in the diagnosis of SMA syndrome and the need for increased awareness of this entity. This will improve early recognition in order to reduce irrelevant tests and unnecessary treatments.

Severe malnutrition causing superior mesenteric artery syndrome in an adolescent with Triple A syndrome

2016 ◽  
Vol 29 (10) ◽  
Author(s):  
Christy Foster ◽  
Abha Choudhary
Keyword(s):  
Superior Mesenteric Artery ◽  
Adrenal Insufficiency ◽  
Mesenteric Artery ◽  
Delayed Diagnosis ◽  
Superior Mesenteric Artery Syndrome ◽  
Adolescent Male ◽  
Severe Malnutrition ◽  
Triple A Syndrome ◽  
Allgrove Syndrome ◽  
Sma Syndrome

AbstractTriple A syndrome, formerly known as Allgrove syndrome (AS), is characterized by achalasia, alacrima and adrenal insufficiency. Here we report an adolescent male with adrenal insufficiency who developed severe malnutrition secondary to a delayed diagnosis of achalasia. The severe malnutrition in our patient led to superior mesenteric artery (SMA) obstruction syndrome. Severe malnutrition to the point of SMA syndrome has not been previously described in the literature in Triple A syndrome.

scholarly journals PATTERN OF CO-MORBIDITIES IN CHILDREN WITH SEVERE ACUTE MALNUTRITION ADMITTED IN MTC AT M.G. HOSPITAL BHILWARA, RAJASTHAN

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Sunil Kumar Dadhich ◽  
Kuldeep Singh Rajpoot
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Severe Malnutrition ◽  
Age Group ◽  
Morbid Condition ◽  
Who Criteria ◽  
Co Morbidity ◽  
Treatment Centre ◽  
High Index Of Suspicion ◽  
Acute Severe Malnutrition

Background: A round the globe nearly 20 million children below the age of five, having Severe Acute Malnutrition (SAM) and contributing to one million deaths every year in this age group. To study the pattern of co-morbidities in children having Severe Acute Malnutrition in MTC attached to a teaching hospital. Methods: This prospective study was carried out in the MTC attached to Department of Pediatrics, M.G. Hospital Bhilwara, Rajasthan. All children between One to sixty months of age with severe acute malnutrition (SAM) admitted in the Malnutrition Treatment Centre were included. WHO criteria were followed for diagnosis and need for admissions in children suffering from severe acute malnutrition. Results: Out of 200 children having SAM 55.00% children were having one co-morbidity, 27.00% were having two co-morbidity and 10.00% were having more than two co-morbidty. Conclusions: It is imperative to suspect and anticipate co-morbid condition in these children. High index of suspicion for these co-morbidities is the key to reduce mortality and better outcome in children having acute severe malnutrition. Keywords: sever acute malnutrition (SAM), malnutrition treatment corner (MTC), co-morbidity

scholarly journals A clinical course of a patient with anorexia nervosa receiving surgery for superior mesenteric artery syndrome

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Ken Kurisu ◽  
Yukari Yamanaka ◽  
Tadahiro Yamazaki ◽  
Ryo Yoneda ◽  
Makoto Otani ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Anorexia Nervosa ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Rare Complication ◽  
Nutrition Therapy ◽  
Psychological Status ◽  
Sma Syndrome

Abstract Background Superior mesenteric artery (SMA) syndrome is a well-known but relatively rare complication of anorexia nervosa. Although several reports have proposed surgery for SMA syndrome associated with anorexia nervosa, these have shown poor outcomes or did not reveal the long-term weight course. Thus, the long-term effectiveness of surgery for SMA syndrome in such cases remains unclear. This case report describes a patient with anorexia nervosa who underwent surgery for SMA syndrome. Case presentation An 18-year-old woman presented with anorexia nervosa when she was 16 years old. She also presented with SMA syndrome, which seemed to be caused by weight loss due to the eating disorder. Nutrition therapy initially improved her body weight, but she ceased treatment. She reported that symptoms related to SMA syndrome had led to her weight loss and desired to undergo surgery. Laparoscopic duodenojejunostomy was performed, but her body weight did not improve after the surgery. The patient eventually received conservative nutritional treatment along with psychological approaches, which led to an improvement in her body weight. Conclusions The case implies that surgery for SMA syndrome in patients with anorexia nervosa is ineffective for long-term weight recovery and that conservative treatment can sufficiently improve body weight; this is consistent with the lack of evidence on the topic and reports on potential complications of surgery. Due to difficulties in assessing psychological status, consultation with specialists on eating disorders is necessary for treating patients with severely low body weight.

scholarly journals Superior Mesenteric Artery Syndrome: Clinical, Endoscopic, and Radiological Findings

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Emanuele Sinagra ◽  
Dario Raimondo ◽  
Domenico Albano ◽  
Valentina Guarnotta ◽  
Melania Blasco ◽  
...  
Keyword(s):  
Weight Loss ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Control Group ◽  
Diagnosis And Management ◽  
Sma Syndrome ◽  
Aortomesenteric Angle ◽  
Cect Scan ◽  
Enhanced Computed Tomography ◽  
Aortomesenteric Distance

Background. The superior mesenteric artery (SMA) syndrome is a rare entity presenting with upper gastrointestinal tract obstruction and weight loss. Studies to determine the optimal methods of diagnosis and treatment are required. Aims and Methods. This study aims at analyzing the clinical presentation, diagnosis, and management of SMA syndrome. Ten cases of SMA syndrome out of 2074 esophagogastroduodenoscopies were suspected. A contrast-enhanced computed tomography (CECT) scan was performed to confirm the diagnosis. After, a gastroenterologist and a nutritionist personalized the therapy. Furthermore, we compared the demographical, clinical, endoscopic, and radiological parameters of these cases with a control group consisting of 10 cases out of 2380 EGDS of initially suspected (but not radiologically confirmed) SMA over a follow-up 2-year period (2015-2016). Results. The prevalence of SMA syndrome was 0.005%. Median age and body mass index were 23.5 years and 21.5 kg/m2, respectively. Symptoms developed between 6 and 24 months. Median aortomesenteric angle and aorta-SMA distance were 22 and 6 mm, respectively. All patients improved on conservative treatment. In our series, a marked (>5 kg) weight loss (p=0.006) and a long-standing presentation (more than six months in 80% of patients) (p=0.002) are significantly related to a diagnosis of confirmed SMA syndrome at CECT after an endoscopic suspicion. A “resembling postprandial distress syndrome dyspepsia” presentation may be helpful to the endoscopist in suspecting a latent SMA syndrome (p=0.02). The narrowing of both the aortomesenteric angle (p=0.001) and the aortomesenteric distance (p<0.001) was significantly associated with the diagnosis of SMA after an endoscopic suspicion; however, the narrowing of the aortomesenteric distance seemed to be more accurate, rather than the narrowing of the aortomesenteric angle. Conclusion. SMA syndrome represents a diagnostic and therapeutic challenge. Our results show the following findings: the importance of the endoscopic suspicion of SMA syndrome; the preponderance of a long-standing and chronic onset; a female preponderance; the importance of the nutritional counseling for the treatment; no need of surgical intervention; and better diagnostic accuracy of the narrowing of the aorta-SMA distance. Larger prospective studies are needed to clarify the best diagnosis and management of the SMA syndrome.

Hypothalamic Germinoma Masquerading as Superior Mesenteric Artery (SMA) Syndrome

2013 ◽  
Vol 19 (1) ◽  
pp. e29-e34 ◽  
Author(s):  
Shireene Vethakkan ◽  
Yogeswari Venugopal ◽  
Alexander Tan ◽  
Sharmila Paramasivam ◽  
Jeyakantha Ratnasingam ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Sma Syndrome

scholarly journals The effects of malnutrition on cardiac function in African children

2015 ◽  
Vol 101 (2) ◽  
pp. 166-171 ◽  
Author(s):  
Jonathan A Silverman ◽  
Yamikani Chimalizeni ◽  
Stephen E Hawes ◽  
Elizabeth R Wolf ◽  
Maneesh Batra ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiac Function ◽  
Severe Acute Malnutrition ◽  
Resistance Index ◽  
Stroke Volume Index ◽  
Acute Malnutrition ◽  
Volume Index ◽  
Severe Malnutrition ◽  
Systemic Vascular Resistance Index ◽  
Malnourished Children

ObjectiveCardiac dysfunction may contribute to high mortality in severely malnourished children. Our objective was to assess the effect of malnutrition on cardiac function in hospitalised African children.DesignProspective cross-sectional study.SettingPublic referral hospital in Blantyre, Malawi.PatientsWe enrolled 272 stable, hospitalised children ages 6–59 months, with and without WHO-defined severe acute malnutrition.Main outcome measuresCardiac index, heart rate, mean arterial pressure, stroke volume index and systemic vascular resistance index were measured by the ultrasound cardiac output monitor (USCOM, New South Wales, Australia). We used linear regression with generalised estimating equations controlling for age, sex and anaemia.ResultsOur primary outcome, cardiac index, was similar between those with and without severe malnutrition: difference=0.22 L/min/m2 (95% CI −0.08 to 0.51). No difference was found in heart rate or stroke volume index. However, mean arterial pressure and systemic vascular resistance index were lower in children with severe malnutrition: difference=−8.6 mm Hg (95% CI −12.7 to −4.6) and difference=−200 dyne s/cm5/m2 (95% CI −320 to −80), respectively.ConclusionsIn this largest study to date, we found no significant difference in cardiac function between hospitalised children with and without severe acute malnutrition. Further study is needed to determine if cardiac function is diminished in unstable malnourished children.

scholarly journals Superior Mesenteric Artery Syndrome with Abdominal Compartment Syndrome

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Kevin Reece ◽  
Rachel Day ◽  
Janna Welch
Keyword(s):  
Superior Mesenteric Artery ◽  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Mesenteric Artery ◽  
Inferior Vena ◽  
Vena Cava ◽  
Exploratory Laparotomy ◽  
Sensory Function ◽  
Sma Syndrome ◽  
Abdominal Compartment

Superior Mesenteric Artery (SMA) syndrome is a condition in which the duodenum becomes compressed between the SMA and the aorta, resulting in bowel obstruction which subsequently compresses surrounding structures. Pressure on the inferior vena cava (IVC) and aorta decreases cardiac output which compromises distal blood flow, resulting in abdominal compartment syndrome with ischemia and renal failure. A 15-year-old male with SMA syndrome presented with 12 hours of pain, a distended, rigid abdomen, mottled skin below the waist, and decreased motor and sensory function in the lower extremities. Exploratory laparotomy revealed ischemic small bowel and stomach with abdominal compartment syndrome. Despite decompression, the patient arrested from hyperkalemia following reperfusion.

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