Superior Mesenteric Artery Syndrome: A Community Hospital Case Series

Superior mesenteric artery syndrome is an obstruction of the small bowel between the aorta and the superior mesenteric artery. Patients with this disease are initially managed medically and those patients who fail medical treatment require surgery. A retrospective case series of thirteen patients diagnosed with SMAS at Flushing Hospital, Flushing, NY, from 2011 to 2020 was performed. Descriptive statistics were used to summarize the characteristics of the entire cohort, and comparative statistics were used to compare the patients who failed medical treatment and required surgery to those who were successfully managed medically. Nine patients were managed conservatively and four patients required operative intervention. BMI was significantly lower in patients requiring operation compared to those who were successfully managed medically. This retrospective community hospital case series adds to the literature on SMAS and provides evidence of BMI as a potential predictor of requiring surgery in SMAS.

A CASE REPORT : A CASE OF SUPERIOR MESENTERIC ARTERY SYNDROME

Superior mesenteric artery (SMA) syndrome is an uncommon but well recognized clinical entity characterized by compression of the third, or transverse, portion of the duodenum between the aorta and the superior mesenteric artery. This results in chronic, intermittent, or acute complete or partial duodenal obstruction. Superior mesenteric artery syndrome was rst described in 1861 by Von Rokitansky, who proposed that its cause was obstruction of the third part of the duodenum as a result of arterio-mesenteric compression. Some studies report the incidence of superior mesenteric artery syndrome to be 0.1- 0.3%.

Superior mesenteric artery syndrome treated successfully by endoscopy-assisted jejunal feeding tube placement

We report the case of a 31-year-old man with superior mesenteric artery syndrome after reoperation due to postoperative complications from rectal cancer. Although initial total parenteral nutrition (TPN) therapy failed, he underwent endoscopy-assisted feeding tube placement without complications instead of surgery. After 2 weeks of dual feeding (enteral feeding and TPN), he improved, gaining 6 kg; and an oral diet was advanced.