• ischemia
  • Each year in the United States, many patients undergo resection of long segments of small intestine for various disorders, including inflammatory bowel disease (IBD), malignancy, mesenteric ischemia, and others. (medscape.com)
  • gastrointestinal
  • 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 instestinal conditions with a higher diagnostic frequency. (wikipedia.org)
  • The inflammatory response leads to the secondary manifestations of pancreatitis: hypovolemia from capillary permeability, acute respiratory distress syndrome, disseminated intravascular coagulations, renal failure, cardiovascular failure, and gastrointestinal hemorrhage. (wikipedia.org)
  • As opposed to traditional imaging modalities like upper gastrointestinal and mesenteric arteriography, which depict either the bowel or vasculature respectively, CT enables direct visualization of obstructed bowel owing to duodenal compression by the SMA. (ctisus.com)
  • proximal
  • The SMA syndrome is thought to develop as the result of an abnormally narrow angle between the proximal SMA and the aorta, for which a number of predisposing factors have been described. (hindawi.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)
  • Intrinsic or extrinsic blockage of the small bowel leads to accumulating secretions that dilate the intestine proximal to the obstruction. (medscape.com)
  • This sequence may occur more rapidly in a closed-loop obstruction with no proximal escape for bowel contents. (medscape.com)
  • 1861
  • SMA syndrome was first described in 1861 by Carl Freiherr von Rokitansky in victims at autopsy, but remained pathologically undefined until 1927 when Wilkie published the first comprehensive series of 75 patients. (wikipedia.org)
  • Vascular
  • [ 1 ] Any disease, traumatic injury, vascular accident, or other pathology that leaves less than 200 cm of viable small bowel or results in a loss of 50% or more of the small intestine places the patient at risk for developing short-bowel syndrome. (medscape.com)
  • visceral
  • 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)
  • causes
  • The final common etiologic factor in all causes of short-bowel syndrome is the functional or anatomic loss of extensive segments of small intestine so that absorptive capacity is severely compromised. (medscape.com)
  • Other less common causes include tobacco smoking, stress due to serious illness, Behcet disease, Zollinger-Ellison syndrome, Crohn disease and liver cirrhosis, among others. (wikipedia.org)
  • small intestine
  • Superior mesenteric artery enter the hepatic artery: A case in ten, the gastroepiploic arterial arch greater omentum from a cialis one day review the small intestine lymphoproliferative disorders different to non-hodgkin's lymphoma later transformed into hair follicles. (buffalo.edu)
  • Although resection of the colon alone typically does not result in short-bowel syndrome, the condition's presence can be a critical factor in the management of patients who lose significant amounts of small intestine. (medscape.com)
  • Not all patients with loss of significant amounts of small intestine develop short-bowel syndrome. (medscape.com)
  • angle
  • 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)
  • venous
  • This is followed by venous obstruction, which accelerates the edema process because blood enters the affected bowel segment but does not have a drainage route. (medscape.com)
  • typically
  • however, the SMA syndrome is typically managed conservatively in the first instance, consistent with the approach described in this case. (hindawi.com)
  • Gastric
  • and gastric decompression being an intermitant problem) and then TPN, she eventually went for a duodenal-jejunal anastamosis (done in continunity, not roux-y). (for-surgeons.com)
  • necrosis
  • If, however, the caspases are depleted due to either chronic ethanol exposure or through a severe insult then necrosis can predominate. (wikipedia.org)
  • abdomen
  • To our knowledge, there are few reports in the literature describing the coexistence of these two conditions and so we take this opportunity to highlight a rare cause of the acute abdomen that might otherwise be overlooked in cases of nonspecific abdominal findings and potentially unremarkable initial investigations. (hindawi.com)
  • Nutcracker
  • We report a case of SMA syndrome and Nutcracker phenomenon in a 19-year-old female who presented to our emergency department with a short history of epigastric pain and emesis. (hindawi.com)
  • We describe a rare emergency presentation of SMA syndrome with coexisting Nutcracker phenomenon. (hindawi.com)
  • Patients
  • Food fear" is a common development among patients with the chronic form of SMA syndrome. (wikipedia.org)
  • 2) Many motility mavens do not believe in SMA syndrome - they see all the post op patients who don't get better. (for-surgeons.com)
  • Various nonoperative procedures can leave patients with a functional short-bowel syndrome. (medscape.com)
  • The subset of patients with clinically significant malabsorption and malnutrition are said to have developed short-bowel syndrome. (medscape.com)
  • Patients with short-bowel syndrome are now routinely treated with TPN, especially early in their course. (medscape.com)
  • diagnosis
  • There have been reported cases of a tentative diagnosis of AN, where upon treatment for SMA syndrome the patient is asymptomatic. (wikipedia.org)
  • clinical
  • Recognition of SMA syndrome as a distinct clinical entity is controversial, due in part to its possible confusion with a number of other conditions, though it is now widely acknowledged. (wikipedia.org)
  • approach
  • Resect and discard the bay area could be effective in reducing diabetic macular edema if one of the interaction of cytochrome b, an inguinal approach is to assess the clonality of duodenal ulcers depression prostate diseases menstrual and menopausal disorders skin disorder loss of control of diabetes may help in prevention, as do other antibodies. (buffalo.edu)