Aortomesenteric distanceDuodenumIntermittentExistence of SMA syndromeCast syndromeComplicationGastricAngleDiagnosisCompressionMalnutritionFrequencyFormsAnorexiaRiskKnown as Wilkie's syndromeIntestinal obstructionCompressed between the abdominal aortaMassive gastric dilatationUncommonIleusScoliosisBACKGROUND SuperiorRetroperitonealAbdominalSpontaneousAnorexia nervosaMechanicalSymptoms0.013DiagnosticRareClinicalConditions
Aortomesenteric distance1
- In addition, the aortomesenteric distance in superior mesenteric artery syndrome is decreased to 2-8 mm (normal is 10-20 mm). (medscape.com)
Duodenum8
- 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)
- [ 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)
- 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)
- 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)
- Superior mesenteric artery (SMA) syndrome is a gastro-vascular disorder in which the third and final portion of the duodenum is compressed between the abdominal aorta (AA) and the overlying superior mesenteric artery. (wikipedia.org)
- The acute form of SMA syndrome develops rapidly after traumatic incidents that forcibly hyper-extend the SMA across the duodenum, inducing the obstruction, or sudden weight loss for any reason. (wikipedia.org)
- The gastroduodenal artery (GDA) supplies blood to the donor duodenum and pancreas but is commonly ligated during procurement. (bvsalud.org)
Intermittent3
- This results in chronic, intermittent, or acute complete or partial duodenal obstruction. (medscape.com)
- SMA syndrome is also known as Wilkie's syndrome, cast syndrome, mesenteric root syndrome, chronic duodenal ileus and intermittent arterio-mesenteric occlusion. (wikipedia.org)
- citation needed] Patients with the chronic, congenital form of SMA syndrome predominantly have a lengthy or even lifelong history of abdominal complaints with intermittent exacerbations depending on the degree of duodenal compression. (wikipedia.org)
Existence of SMA syndrome1
- Despite multiple case reports, there has been controversy surrounding the diagnosis and even the existence of SMA syndrome since symptoms do not always correlate well with radiologic findings, and may not always improve following surgical correction. (wikipedia.org)
Cast syndrome1
- Nonetheless, the entity (also called cast syndrome) is a well-known complication of scoliosis surgery, anorexia, and trauma. (medscape.com)
Complication1
- One devastating complication is a duodenal leak at the site of enteroenteric anastomosis. (bvsalud.org)
Gastric3
- 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)
- Here, we reviewed registers from 855 patients with Crohn's disease treated in our service from January 2007 to December 2020 and found 4 cases of duodenal fistula and 1 case of gastric fistula. (bvsalud.org)
- They then underwent surgical treatment with resection of the affected segment and duodenal or gastric closure with covering by an omental patch. (bvsalud.org)
Angle3
- This rare, potentially life-threatening syndrome is typically caused by an angle of 6-25° between the AA and the SMA, in comparison to the normal range of 38-56°, due to a lack of retroperitoneal and visceral fat (mesenteric fat). (wikipedia.org)
- However, a narrow SMA angle alone is not enough to make a diagnosis, because patients with a low BMI, most notably children, have been known to have a narrow SMA angle with no symptoms of SMA syndrome. (wikipedia.org)
- SMA syndrome is thus triggered by any condition involving an insubstantial cushion and narrow mesenteric angle. (wikipedia.org)
Diagnosis4
- [ 2 ] Approximately 0.013-0.78% of barium upper GI studies evaluating for superior mesenteric artery syndrome support the diagnosis. (medscape.com)
- In a review of the literature, approximately 0.013-0.78% of the findings from upper GI tract barium studies support a diagnosis of superior mesenteric artery syndrome. (medscape.com)
- Merrett ND, Wilson RB, Cosman P, Biankin AV. Superior mesenteric artery syndrome: diagnosis and treatment strategies. (medscape.com)
- Diagnosis may follow X-ray examination revealing duodenal dilation followed by abrupt constriction proximal to the overlying SMA, as well as a delay in transit of four to six hours through the gastroduodenal region. (wikipedia.org)
Compression2
- Signs and symptoms include early satiety, nausea, vomiting, extreme "stabbing" postprandial abdominal pain (due to both the duodenal compression and the compensatory reversed peristalsis), abdominal distention/distortion, burping, external hypersensitivity or tenderness of the abdominal area, reflux, and heartburn. (wikipedia.org)
- This, in turn, increases the duodenal compression, which worsens the underlying cause, creating a cycle of worsening symptoms. (wikipedia.org)
Malnutrition1
- In some cases of SMA syndrome, severe malnutrition accompanying spontaneous wasting may occur. (wikipedia.org)
Frequency1
- SMA syndrome is thus considered only after patients have undergone an extensive evaluation of their gastrointestinal tract including upper endoscopy, and evaluation for various malabsorptive, ulcerative and inflammatory intestinal conditions with a higher diagnostic frequency. (wikipedia.org)
Forms1
- SMA syndrome can present in two forms: chronic/congenital or acute/induced. (wikipedia.org)
Anorexia2
- citation needed] SMA syndrome is usually difficult to differentiate with anorexia nervosa. (wikipedia.org)
- Patients with SMA syndrome can be hindered restoring weight in those with anorexia nervosa. (wikipedia.org)
Risk1
- CONCLUSIONS: This study identified improved intraoperative duodenal tissue oxygen saturation in the GDA-R group with an associated reduction in pancreatic leaks and CCI® morbidity risk. (bvsalud.org)
Known as Wilkie's syndrome2
- SMA syndrome is also known as Wilkie's syndrome, cast syndrome, mesenteric root syndrome, chronic duodenal ileus and intermittent arterio-mesenteric occlusion. (wikipedia.org)
- BACKGROUND: Superior mesenteric artery syndrome (SMAS), also known as Wilkie's syndrome, is a rare disease that mainly presents as intestinal obstruction with a variable incidence ranging from 0.013 to 0.3% (Salehzadeh et al. (bvsalud.org)
Intestinal obstruction4
- Baltazar U, Dunn J, Floresguerra C. Superior mesenteric artery syndrome: an uncommon cause of intestinal obstruction. (medscape.com)
- Mosalli R, El-Bizre B, Farooqui M, Paes B. Superior mesenteric artery syndrome: a rare cause of complete intestinal obstruction in neonates. (medscape.com)
- Superior mesenteric artery (SMA) syndrome is an uncommon cause of intestinal obstruction due to vascular compression of the third portion of the duodenum (D3) between the aorta and the SMA. (medscape.com)
- CONCLUSION: Whenever a patient complains of vomiting and chronic abdominal pain, intestinal obstruction is suspected, Common differential diagnoses were excluded and the cause is anonymous, we should consider superior mesenteric artery syndrome. (bvsalud.org)
Compressed between the abdominal aorta1
- Superior mesenteric artery (SMA) syndrome is a gastro-vascular disorder in which the third and final portion of the duodenum is compressed between the abdominal aorta (AA) and the overlying superior mesenteric artery. (wikipedia.org)
Massive gastric dilatation2
- Lim JE, Duke GL, Eachempati SR. Superior mesenteric artery syndrome presenting with acute massive gastric dilatation, gastric wall pneumatosis, and portal venous gas. (medscape.com)
- We present the case of an 83-year-old Japanese man who presented with shock because of massive gastric dilatation due to SMA syndrome and developed multi-organ ischemia. (bvsalud.org)
Uncommon3
- Superior mesenteric artery syndrome: an uncommon cause of feeding intolerance in infancy. (medscape.com)
- Superior mesenteric artery (SMA) syndrome has been reported as an uncommon condition of external vascular compression of the SMA particularly after rapid weight loss, body casts, or after corrective surgery for spinal deformities, usually within the first few weeks after surgery. (sicot-j.org)
- Superior mesenteric artery syndrome (SMAS) is an uncommon condition of the gastrointestinal (GI) tract with external vascular compression of the third part of the duodenum causing partial or complete obstruction secondary to decreased aortomesenteric angle and distance to 6-16° and 2-8 mm, respectively [ 1 - 3 ]. (sicot-j.org)
Ileus1
- In addition, superior mesenteric artery (SMA) syndrome should be differentiated from other causes of megaduodenum or duodenal ileus, including diabetes mellitus, collagen vascular conditions, and chronic idiopathic intestinal pseudoobstruction. (medscape.com)
Scoliosis3
- Low body mass index: a risk factor for superior mesenteric artery syndrome in adolescents undergoing spinal fusion for scoliosis. (medscape.com)
- This is a retrospective report of a case of a non-verbal autistic female patient who started to develop SMA syndrome at the age of 16, 4 years after posterior spinal fusion surgery for scoliosis. (sicot-j.org)
- Spinal surgeons should maintain a high index of suspicion for diagnosis of SMA syndrome even years after scoliosis surgery, especially for patients with communication problems, like the case we present here. (sicot-j.org)
BACKGROUND Superior1
- BACKGROUND Superior mesenteric artery (SMA) syndrome, a rare condition in which the SMA and aorta occlude the third duodenal portion, can cause serious complications. (bvsalud.org)
Retroperitoneal2
- owing to depletion of the mesenteric and retroperitoneal fat surrounding the SMA. (medscape.com)
- This rare, potentially life-threatening syndrome is typically caused by an angle of 6-25° between the AA and the SMA, in comparison to the normal range of 38-56°, due to a lack of retroperitoneal and visceral fat (mesenteric fat). (wikipedia.org)
Abdominal4
- Saraya T, Kurai D, Ariga M, Nakamoto K, Koide T, Tamura M. Superior mesenteric artery syndrome caused by huge mycotic abdominal aortic aneurysm. (medscape.com)
- Signs and symptoms include early satiety, nausea, vomiting, extreme "stabbing" postprandial abdominal pain (due to both the duodenal compression and the compensatory reversed peristalsis), abdominal distention/distortion, burping, external hypersensitivity or tenderness of the abdominal area, reflux, and heartburn. (wikipedia.org)
- citation needed] Patients with the chronic, congenital form of SMA syndrome predominantly have a lengthy or even lifelong history of abdominal complaints with intermittent exacerbations depending on the degree of duodenal compression. (wikipedia.org)
- Case presentation An 8-years-old Arabian male patient was admitted to the gastrointestinal department at the pediatric hospital in Damascus, Syria, with complaints of chronic abdominal pain and periodic vomiting since he was two years old. (bvsalud.org)
Spontaneous2
- Unusual complication of superior mesenteric artery syndrome: spontaneous upper gastrointestinal bleeding with hypovolemic shock. (medscape.com)
- In some cases of SMA syndrome, severe malnutrition accompanying spontaneous wasting may occur. (wikipedia.org)
Anorexia nervosa2
- citation needed] SMA syndrome is usually difficult to differentiate with anorexia nervosa. (wikipedia.org)
- Patients with SMA syndrome can be hindered restoring weight in those with anorexia nervosa. (wikipedia.org)
Mechanical2
- Mechanical obstruction secondary to peptic ulcer disease or duodenal web should also be considered. (medscape.com)
- Endoscopy revealed mechanical obstruction of the gastric cardia and gastric mucosal ischemia. (bvsalud.org)
Symptoms3
- This, in turn, increases the duodenal compression, which worsens the underlying cause, creating a cycle of worsening symptoms. (wikipedia.org)
- We present here a case of SMAS, where the symptoms ensued 4 years after surgery. (sicot-j.org)
- Whether these symptoms heralded or were possibly part of the clinical presentation of her later diagnosed SMAS cannot be confirmed. (sicot-j.org)
0.0131
- SMAS has an estimated prevalence of 0.013%-0.3% in the general population. (medscape.com)
Diagnostic2
- Endoscopic ultrasound is a useful diagnostic test for superior mesenteric artery syndrome in children. (medscape.com)
- SMA syndrome is thus considered only after patients have undergone an extensive evaluation of their gastrointestinal tract including upper endoscopy, and evaluation for various malabsorptive, ulcerative and inflammatory intestinal conditions with a higher diagnostic frequency. (wikipedia.org)
Rare1
- CONCLUSIONS SMA syndrome with extensive ischemia and infarction is rare. (bvsalud.org)
Clinical1
- Clinical and nutritional outcomes in children with idiopathic superior mesenteric artery syndrome. (medscape.com)
Conditions1
- It is distinct from nutcracker syndrome, which is the entrapment of the left renal vein between the AA and the SMA, although it is possible to be diagnosed with both conditions. (wikipedia.org)