Superior Mesenteric Artery Syndrome: Diagnosis and Treatment Strategies

• Published in: Journal of gastrointestinal surgery Vol. 13; no. 2; pp. 287 - 292
• Main Authors: Merrett, N. D., Wilson, R. B., Cosman, P., Biankin, A. V.
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.02.2009; Springer Nature B.V
• Subjects: Adolescent; Adult; Age Factors; Diabetes; Diagnosis, Differential; Female; Gastroenterology; Humans; Male; Medicine; Medicine & Public Health; Original Article; Risk Factors; Superior Mesenteric Artery Syndrome - diagnosis; Superior Mesenteric Artery Syndrome - psychology; Superior Mesenteric Artery Syndrome - surgery; Surgery; Weight control; Young Adult; Cast syndrome; Duodenojejunal bypass; Superior mesenteric artery syndrome; Laparoscopy; Strong’s procedure; Wilkie’s syndrome; Duodenal obstruction
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-008-0695-4

Introduction Superior mesenteric artery (SMA) syndrome is an unusual cause of vomiting and weight loss resulting from the compression of the third part of the duodenum by the SMA. Various medical and psychiatric conditions may result in the initial rapid weight loss which causes narrowing of the aortomesenteric angle. The vomiting and obstructive syndrome is then self-perpetuated regardless of the initiating factors. The young age and nonspecific symptoms often lead to a delay in diagnosis. Discussion A series of eight cases is presented reviewing the presentation, investigations, surgical treatment by division of duodenum and duodenojejunostomy, and outcomes. Conclusion SMA syndrome is a well-described entity which must be considered as a cause of vomiting associated with significant weight loss in young adults. Surgical treatment should be allied with psychological assessment to treat any underlying psychosocial abnormality.