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. (medscape.com)
The superior mesenteric artery usually forms an angle of approximately 45° (range, 38-56°) with the abdominal aorta, and the third part of the duodenum crosses caudal to the origin of the superior mesenteric artery, coursing between the superior mesenteric artery and aorta. (medscape.com)
Any factor that sharply narrows the aortomesenteric angle to approximately 6-25° can cause entrapment and compression of the third part of the duodenum as it passes between the superior mesenteric artery and aorta, resulting in SMA syndrome. (medscape.com)
Superior mesenteric artery syndrome (SMA syndrome) or Wilkie's syndrome is a rare etiology of duodenal obstruction due to compression of the third portion of the duodenum between the superior mesenteric artery and the aorta. (ejcrim.com)
it is of varying size and is wedged between the superior mesenteric vessels (vein on the right, artery on the left) in front and the aorta behind it. (medscape.com)
The body of the pancreas lies over the visceral portion of the suprarenal aorta (origins of celiac axis, superior mesenteric artery, and bilateral renal arteries) and the left renal artery and vein. (basicmedicalkey.com)
There was compression of D3 (third part of duodenum) between the aorta and SMA ( Figs. 1 and 2 ). (journalmc.org)
SMA syndrome, also known as aortomesenteric duodenal compression or duodenal vascular compression or Wilkie's syndrome or Cast syndrome, is a rare clinical entity that results from the compression of the third part of the duodenum as it passes between the overlying SMA and the aorta [ 1 ]. (journalmc.org)
A barium swallow X-ray with small bowel follow-through and computed tomography scan demonstrated remarkable duodenal narrowing between the superior mesenteric artery and the aorta, consistent with superior mesenteric artery syndrome. (biomedcentral.com)
The small bowel obstruction occurred as a result of weight loss secondary to the anorexia, which then led to loss of the omental fat pad and consequent compression of the duodenum between the superior mesenteric artery (SMA) and the aorta. (biomedcentral.com)
SMA syndrome is generally felt to result from compression of the duodenum between the superior mesenteric artery anteriorly/dorsally and the aorta (and behind the aorta, the vertebral column) posteriorly/ventrally [ 4 ]. (biomedcentral.com)
In the absence of an appropriate fatty scaffolding, the angle at which the SMA branches from the aorta is reduced resulting in compression of the third portion of the duodenum between the SMA and the aorta [ 4 ]. (biomedcentral.com)
The distribution of the systemic arteries is like a ramified tree, the common trunk of which, formed by the aorta, commences at the left ventricle, while the smallest ramifications extend to the peripheral parts of the body and the contained organs (see the image below). (medscape.com)
Three branches are given off from the arch of the aorta: the brachiocephalic trunk, the left common carotid artery, and the left subclavian artery. (medscape.com)
The brachiocephalic trunk is the largest branch of the arch of the aorta and divides into the right common carotid and right subclavian arteries. (medscape.com)
[ 1 ] Superior mesenteric artery syndrome was first described in 1861 by Von Rokitansky, who proposed that its cause was obstruction of the third part of the duodenum as a result of arteriomesenteric compression. (medscape.com)
Baltazar U, Dunn J, Floresguerra C. Superior mesenteric artery syndrome: an uncommon cause of intestinal obstruction. (medscape.com)
Duodenal obstruction by compression from the superior mesenteric artery (SMA) can be managed using minimally invasive techniques. (journalmc.org)
While superior mesenteric artery syndrome is an uncommon cause of small bowel obstruction, the general pediatrician and child psychiatrist should be aware of this complication of anorexia nervosa. (biomedcentral.com)
Alternatively, other causes implicated in superior mesenteric artery syndrome include high insertion of the duodenum at the ligament of Treitz, a low origin of the superior mesenteric artery, and compression of the duodenum due to peritoneal adhesions. (medscape.com)
Delay in the diagnosis of SMA syndrome can result in malnutrition , dehydration , electrolyte abnormalities, gastric pneumatosis and portal venous gas, formation of an obstructing duodenal bezoar, hypovolemia secondary to massive GI hemorrhage, and even death secondary to gastric perforation. (medscape.com)
Lippl F, Hannig C, Weiss W, Allescher H-D, Classen M, Kurjak M. Superior mesenteric artery syndrome: diagnosis and treatment from the gastroenterologist's view. (ejcrim.com)
Superior mesenteric artery (SMA) syndrome is an interesting phenomenon that occurs when the SMA compresses the third part of the duodenum. (journalmc.org)
This case illustrates important points regarding the pathogenesis of superior mesenteric artery syndrome in the setting of anorexia, and it highlights the complexities that arise when managing an adolescent with both medical and psychiatric needs, as well as outlining a viable solution. (biomedcentral.com)
Pancreas9
The pancreas is prismoid in shape and appears triangular in cut section, with superior, inferior, and anterior borders as well as anterosuperior, anteroinferior, and posterior surfaces. (medscape.com)
The head of the pancreas lies in the duodenal C loop in front of the inferior vena cava (IVC) and the left renal vein (see the images below). (medscape.com)
The head of the pancreas has a shared blood supply with the duodenum through the anterior and posterior branches of the superior and inferior pancreaticoduodenal arteries. (basicmedicalkey.com)
The neck of the pancreas overlies the superior mesenteric vein and may have to be divided to expose injuries to the confluence of this vein and the splenic vein or to the proximal portal vein. (basicmedicalkey.com)
The duct of Santorini (accessory pancreatic duct) most commonly branches out superiorly from the duct of Wirsung in the neck of the pancreas and enters the duodenum at the minor papilla ∼2.5 cm proximal to the major papilla. (basicmedicalkey.com)
Wounds of the head of the pancreas are most commonly associated with injuries to the liver, duodenum, and major vascular structures, whereas injuries to the body are frequently associated with perforations of the stomach and transverse colon. (basicmedicalkey.com)
Imaging in the arterial phase can be performed to evaluate mesenteric ischemia, aortic dissection, or aneurysm, and can also be used to improve visualization of the pancreas in patients with upper abdominal pain. (radiologykey.com)
Arterial1
Arteries are the large vessels that carry oxygenated blood away from the heart (except for the pulmonary circuit, in which the arterial blood is deoxygenated). (medscape.com)
Isolated injuries after blunt abdominal trauma are noted in only 20% of the patients with pancreatic injuries, and the most common associated injuries are to the duodenum, liver, and spleen. (basicmedicalkey.com)
it then descends within the thorax on the left side of the vertebral column, passes into the abdominal cavity through the aortic hiatus in the diaphragm, and ends opposite the lower border of the fourth lumbar vertebra by dividing into the right and left common iliac arteries. (medscape.com)
Liver is located in the upper right-hand portion of the abdominal cavity, beneath the diaphragm, and on top of the stomach, right kidney, and intestines. (abcmedicalnotes.com)
Dilation1
A subsequent barium meal and follow-through demonstrated a linear compression at the third part of the duodenum causing dilation of the proximal duodenum. (journalmc.org)
Vessels2
A direct blow with compression of the upper abdomen and its viscera/vessels against the spine is the most common blunt mechanism of injury. (basicmedicalkey.com)
The arteries, in their distribution, communicate with one another (forming what are called anastomoses) and end in minute vessels, called arterioles, which in their turn open into a close-meshed network of microscopic vessels, termed capillaries, the true deliverers of oxygen and nutrients to the cells. (medscape.com)
Inferior2
The uncinate process encompasses the inferior pancreaticoduodenal artery and wraps around the superior mesenteric vein and artery. (basicmedicalkey.com)
The duct of Wirsung (main pancreatic duct) passes through the entire length of the gland just above a line halfway between the superior and inferior edges and enters the left side of the common bile duct to form the ampulla of Vater. (basicmedicalkey.com)
Gallbladder2
In 1946, Waugh and Clagett described a formal en-bloc resection of the gallbladder with the common bile duct (CBD), gastric antrum, duodenum, and pancreatic head performed as a one-stage procedure, which we recognize today as the classic pancreaticoduodenectomy. (medscape.com)
The common hepatic duct transports the bile made by the liver cells to the gallbladder and duodenum (the first part of the small intestine) via the common bile duct. (abcmedicalnotes.com)
Vein1
Although innumerable details of pancreaticoduodenectomy yield to continued innovation, a comprehensive discussion of intraoperative variants (ie, duct to mucosa vs invagination of the pancreaticojejunal anastomosis, diverse approaches to vein resection and reconstructions, nuances of each enteric anastomosis, and modifications of Roux-en-Y reconstructions, to name a few) is beyond the scope of this article. (medscape.com)
Stomach1
CT scan of abdomen showed dilatation of stomach, first and second part of duodenum. (journalmc.org)
Midline1
It descends in front of the vertebral column and ends on the body of the fourth lumbar vertebra, commonly a little to the left of the midline, by dividing into the 2 common iliac arteries. (medscape.com)
Abdomen2
Multi-row helical detector CT scans are capable of scanning the abdomen in less than 30 seconds and can detect free air, free fluid, abnormal bowel wall enhancement, bowel wall thickening, and mesenteric infiltration. (medscape.com)
CT scan of abdomen showing decreased aorto-mesenteric distance. (journalmc.org)
Include1
Examples would include compression from the lower rim of the steering wheel in an unrestrained driver in a deceleration-type motor vehicle crash, by a misplaced lap-type restraint device in a child, or by direct contact with the handlebars of a bicycle in a frontal crash. (basicmedicalkey.com)
Results1
This compression results from the loss of fatty tissue, which surrounds the superior mesenteric artery and its neurovascular pedicle. (biomedcentral.com)
This is promptly followed by aggressive nutritional support, with the goal of increasing body weight to increase retroperitoneal fat tissue and reexpand the aortomesenteric distance, thereby relieving duodenal obstruction. (medscape.com)
it then descends within the thorax on the left side of the vertebral column, passes into the abdominal cavity through the aortic hiatus in the diaphragm, and ends opposite the lower border of the fourth lumbar vertebra by dividing into the right and left common iliac arteries. (medscape.com)
It descends in front of the vertebral column and ends on the body of the fourth lumbar vertebra, commonly a little to the left of the midline, by dividing into the 2 common iliac arteries. (medscape.com)
Distal1
In this procedure, the third portion of duodenum is mobilized to the right of the superior mesenteric vessels (artery and vein), and a side-to-side duodenojejunostomy is created between the third part of duodenum and jejunum distal to ligament of Treitz, to bypass the area of compression created by SMA. (medscape.com)
Pancreas2
These supply the proximal bowel segments from the abdominal esophagus to the pancreas and duodenum. (basicmedicalkey.com)
These supply the middle bowel segments from the pancreas and duodenum to the left colic flexure. (basicmedicalkey.com)
Ligament1
The Strong procedure involves mobilization of the duodenum by dividing the ligament of Treitz. (medscape.com)
Multirow helical detector CT scans are capable of scanning the abdomen in less than 30 seconds and can detect free air, free fluid, abnormal bowel wall enhancement, bowel wall thickening, and mesenteric infiltration. (medscape.com)
Vascular1
The mouth and pharynx can be studied to better advantage later with the dissection of portions of the vascular system. (pdfhost.io)
Small1
The hypothalamus is a portion of the brain that containsa number of small nuclei with a variety of functions. (slideshare.net)