scholarly journals Superior Mesenteric Artery Syndrome: A Worldwide Descriptive Study with Literature Review

2016 ◽  
Vol 4 (2) ◽  
pp. 50-54
Author(s):  
Ruhidayati Awaludin ◽  
Hazimah Ab Rahim ◽  
Dg. Syazana Arivai ◽  
Mostafa Refaie Elkeleny

Background: Superior mesenteric artery syndrome is best described as compression of the third part of duodenum by the superior mesenteric artery, resulting in obstruction. This rare condition has been studied for decades yet remains obscure. This study aimed to analyze different clinical presentations, diagnostic modalities, treatment approaches and outcomes of this condition. Methods: Thirty-five superior mesenteric artery syndrome cases were collected retrospectively from a Facebook group called “Superior Mesenteric Artery Syndrome Awareness & Support”. A questionnaire was designed using Google Forms to obtain the demographics, presenting symptoms, risk factors and co-morbidities, investigations, means of treatment and the outcomes. Data was entered into Microsoft Office Excel for statistical analysis. Results: The median age at diagnosis was 22 years. The median body mass index was 20.8 kg/m2. The median time interval from symptom onset to initial diagnosis was 22 months. The major presenting symptoms were abdominal pain (82.9%), nausea (77.1%), and vomiting (65.7%). Abdominal computed tomography scan with contrast (82.9%) was commonly used for confirmation of diagnosis. Thirteen cases (37.1%) were congenital. Thirty patients (85.7%) had received treatment. The overall management success was only 13.3%. Surgical management (34.3%) was the most commonly used regimen. Conclusion: Diagnosis of superior mesenteric artery syndrome is established after a thorough assessment of the clinical presentations and confirmed with suitable imaging modalities. The choice of treatment should be dependent on the causes and severity as different patients respond differently to therapy. Recurrence is possible in all patients, and a long-term follow up is thus required.

2017 ◽  
Vol 4 (3) ◽  
pp. 1141
Author(s):  
Vikrant Mohan Bhagvat ◽  
Juily Vishwanath Aher ◽  
Nimesh Shah

Superior mesenteric artery syndrome (SMAS) is a rare condition caused by compression of the transverse portion of the duodenum between the superior mesenteric artery (SMA) and the aorta, causing symptoms of duodenal outflow obstruction. We report a case of superior mesenteric artery syndrome in a 25-year-old female associated with rapid loss of weight and intermittent vomiting and resulting in severe duodenal compression that necessitated surgical treatment.


Author(s):  
Ming Li Yee ◽  
Rosemary Wong ◽  
Mineesh Datta ◽  
Timothy Nicholas Fazio ◽  
Mina Mohammad Ebrahim ◽  
...  

Summary Mitochondrial diseases are rare, heterogeneous conditions affecting organs dependent on high aerobic metabolism. Presenting symptoms and signs vary depending on the mutation and mutant protein load. Diabetes mellitus is the most common endocrinopathy, and recognition of these patients is important due to its impact on management and screening of family members. In particular, glycemic management differs in these patients: the use of metformin is avoided because of the risk of lactic acidosis. We describe a patient who presented with gradual weight loss and an acute presentation of hyperglycemia complicated by the superior mesenteric artery syndrome. His maternal history of diabetes and deafness and a personal history of hearing impairment led to the diagnosis of a mitochondrial disorder. Learning points: The constellation of diabetes, multi-organ involvement and maternal inheritance should prompt consideration of a mitochondrial disorder. Mitochondrial encephalomyopathy, lactic acidosis, stroke-like episodes (MELAS) and maternally inherited diabetes and deafness (MIDD) are the most common mitochondrial diabetes disorders caused by a mutation in m.3243A>G in 80% of cases. Metformin should be avoided due to the risk of lactic acidosis. There is more rapid progression to insulin therapy and higher prevalence of diabetic complications compared to type 2 diabetes. Diagnosis of a mitochondrial disorder leads to family screening, education and surveillance for future complications. Superior mesenteric artery syndrome, an uncommon but important cause of intestinal pseudo-obstruction in cases of significant weight loss, has been reported in MELAS patients.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Metin Keskin ◽  
Turgut Akgül ◽  
Adem Bayraktar ◽  
Fatih Dikici ◽  
Emre Balık

Superior mesenteric artery syndrome is a rare condition that causes a proximal small intestinal obstruction due to contraction of the angle between the superior mesenteric artery and the aorta. Scoliosis surgery is one of the 15 reasons for superior mesenteric artery syndrome, which can present with acute or chronic manifestations. Although conservative treatment is usually possible, surgical treatment is required in certain cases that cannot be treated using conservative methods. In this paper, we describe a patient who developed superior mesenteric artery syndrome after scoliosis surgery and was treated with duodenojejunostomy due to failure and complications of conservative treatment.


2020 ◽  
Vol 74 (6) ◽  
pp. 488-491
Author(s):  
Ivana Červinková ◽  
Denisa Pavlovská ◽  
Marcelqa Charvátová ◽  
Jarmila Skotáková

Superior mesenteric artery syndrome (SMAS) is a rare condition characterized by mechanical compression of the third part of the duodenum between the abdominal aorta and the superior mesenteric artery. The relationship between Crohn‘s disease and SMAS is seldom described in literature, although patients with Crohn‘s disease have many predispositions to its development. We describe the case of a 17-year- -old female patient who has been dia gnosed with Crohn‘s disease for several years and has been experiencing symptoms of abdominal discomfort and significant weight loss for five months. Magnetic resonance imaging was a key method for dia gnosing SMAS. In addition, older contrast computed tomography scans were evaluated retrospectively with regards to the aortomesenteric angle and distance, the reduction of which is a diagnostic criterion for SMAS. Our goal is to highlight the importance of measuring these values in patients with Crohn‘s disease for early detection of the risk of SMAS.


2013 ◽  
Vol 2 (1) ◽  
pp. 73-76
Author(s):  
K Dhungel ◽  
S Ansari ◽  
K Ahmad ◽  
PL Sah ◽  
MK Gupta ◽  
...  

Superior mesenteric artery syndrome (SMAS) is a rare condition caused by compression of the third portion of the duodenum between the superior mesenteric artery (SMA) and the aorta, causing symptoms of duodenal outflow obstruction. We report a case of SMAS in a young emaciated female with well-documented diagnostic imaging findings. Nepal Journal of Medical Sciences | Volume 02 | Number 01 | Jan-Jun 2013 | Page 73-76 DOI: http://dx.doi.org/10.3126/njms.v2i1.7657


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