scholarly journals Superior Mesenteric Artery Syndrome: Clinical and Radiological Considerations

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
M. Ezzedien Rabie ◽  
Olajide Ogunbiyi ◽  
Abdullah Saad Al Qahtani ◽  
Sherif B. M. Taha ◽  
Ahmad El Hadad ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Barium Meal ◽  
Clinical Manifestations ◽  
Rare Condition ◽  
Sma Syndrome ◽  
Ligament Of Treitz ◽  
History Of ◽  
Initial Improvement

Background. Superior mesenteric artery (SMA) syndrome is a rare condition of duodenal obstruction, caused by the overlying SMA.Aim. To report on our experience with the management of SMA syndrome, drawing the attention to its existence.Material and Methods. We reviewed our records to identify cases diagnosed with SMA syndrome, in the period from October 1995 to January 2012.Results. Seven patients were identified, one male and six females. Their mean age was 17.1 years. Vomiting and abdominal pain were the presenting complaints in all patients and history of weight loss was present in six of them. In no patient was the diagnosis suspected initially on clinical grounds. Only after radiological investigations was the diagnosis declared. Radiology took the form of gastrografin/barium meal only in four patients and both gastrografin/barium meal and computerized tomography scan in the remaining three. Four patients responded to medical treatment and surgery was performed in the remaining three, with open duodenojejunostomy in two patients and laparoscopic dissection of the ligament of Treitz in the third. Long lasting improvement was sustained in all patients except one in the surgery group who, despite initial improvement, still has infrequent attacks of abdominal pain.Conclusion. Although the clinical manifestations of SMA syndrome are shared with many other disease entities, it has unique radiological as well as endoscopic features, which enables a confident diagnosis to be made. Once diagnosed, conservative treatment with nutritional support and positioning should be tried first. In case of unresponsiveness, surgery may give a lasting cure.

scholarly journals A Model Example: Coexisting Superior Mesenteric Artery Syndrome and the Nutcracker Phenomenon

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Rebecca Nunn ◽  
Jaimie Henry ◽  
Alistair A. P. Slesser ◽  
Rukshan Fernando ◽  
Nebil Behar
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Epigastric Pain ◽  
Left Renal Vein ◽  
Clinical Manifestations ◽  
External Compression ◽  
Nutcracker Phenomenon ◽  
Narrow Angle ◽  
Sma Syndrome ◽  
History Of

Superior mesenteric artery (SMA) syndrome is a rare cause of gastrointestinal obstruction, caused by external compression of the third part of the duodenum by the SMA. It may be associated with the Nutcracker phenomenon: external compression of the left renal vein. 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. 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. 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. Surgical options exist; however, the SMA syndrome is typically managed conservatively in the first instance, consistent with the approach described in this case. The Nutcracker phenomenon may give rise to the Nutcracker syndrome in the presence of typical clinical manifestations; however, these did not feature in this case.

Antibiotic Therapy Did Not Prevent the Rupture of Mycotic Aneurysm of the Superior Mesenteric Artery

2015 ◽  
Vol 18 (3) ◽  
pp. 088
Author(s):  
Ye-tao Li ◽  
Xiao-bin Liu ◽  
Tao Wang
Keyword(s):  
Abdominal Pain ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mycotic Aneurysm ◽  
Acute Abdominal Pain ◽  
Rare Complication ◽  
Emergency Operation ◽  
History Of

<p class="p1"><span class="s1">Mycotic aneurysm of the superior mesenteric artery (SMA) is a rare complication of infective endocarditis. We report a case with infective endocarditis involving the aortic valve complicated by multiple septic embolisms. The patient was treated with antibiotics for 6 weeks. During preparation for surgical treatment, the patient developed acute abdominal pain and was diagnosed with a ruptured SMA aneurysm, which was successfully treated with an emergency operation of aneurysm ligation. The aortic valve was replaced 17 days later and the patient recovered uneventfully. In conclusion, we present a rare case with infective endocarditis (IE) complicated by SMA aneurysm. Antibiotic treatment did not prevent the rupture of SMA aneurysm. Abdominal pain in a patient with a recent history of IE should be excluded with ruptured aneurysm.</span></p>

Endovascular Repair of a Splenic Artery Aneurysm With Anomalous Origin From the Superior Mesenteric Artery

2017 ◽  
Vol 51 (3) ◽  
pp. 152-154 ◽  
Author(s):  
Lalithapriya Jayakumar ◽  
Francis J. Caputo ◽  
Joseph V. Lombardi
Keyword(s):  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Endovascular Repair ◽  
Mesenteric Artery ◽  
Splenic Artery ◽  
Artery Aneurysm ◽  
Recurrent Abdominal Pain ◽  
Anomalous Origin ◽  
Splenic Artery Aneurysm ◽  
History Of

A 22 year old female with a history of recurrent abdominal pain was transferred to our institution with a diagnosis of splenic artery aneurysm identified on imaging. CT angiography of the abdomen and pelvis revealed a partially thrombosed 3.0 cm splenic artery aneurysm without signs of rupture and with an anomalous origin from the superior mesenteric artery. The patient was successfully treated with endovascular exclusion of the aneurysm. Herein we review some of the nuances of endovascular repair of splenic artery aneurysm.

scholarly journals Acute pancreatitis caused by postcholecystectomic pseudoaneurysmatic hemobilia

2019 ◽  
Vol 7 (1) ◽  
pp. 55-57
Author(s):  
Tamzeed Hossain ◽  
Nazmun Nahar Munny ◽  
Chowdhury Rifat Niger ◽  
Hasan Tasmim ◽  
Rawshan Arra Khanam ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Laparoscopic Cholecystectomy ◽  
Obstructive Jaundice ◽  
Gall Bladder ◽  
Superior Mesenteric Artery ◽  
Hepatic Artery ◽  
Mesenteric Artery ◽  
Left Lobe ◽  
History Of

A 50 year old bangladeshi female, came to our emergency with hematemasis ,jaundice and abdominal pain who had a history of laparoscopic cholecystectomy 1 month ago. Patient was diagnosed as acute pancreatitis and obstructive jaundice caused by postcholecystectomic hemobilia. She also had a vascular abnormaly (Her left lobe of liver is supplied by hepatic artery and right love of liver is supplied by accessory hepatic artery which is a branch of superior mesenteric artery, and a sacular aneurysm developed in accessory hepatic artery near the gall bladder fossa (near postcholecystectomy clipping). We are reporting another case of acute pancreatitis after laparoscopic cholecystectomy caused by hemobilia secondary to pseudoaneurysm in accessory hepatic artery originating from superior mesenteric artery. This is probably second such reported case. Bangladesh Crit Care J March 2019; 7(1): 55-57

scholarly journals TRANSIENT ISCHEMIC JEJUNITIS DUE TO SYMPTOMATIC ISOLATED SUPERIOR MESENTERIC ARTERY DISSECTION: CASE REPORT AND REVIEW OF LITERATURE

2016 ◽  
Vol 90 (1) ◽  
pp. 107-112
Author(s):  
Mihaela Mocan ◽  
Ionuț Isaia Jeican ◽  
Mihai Moale ◽  
Romeo Chira
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Acute Abdominal Pain ◽  
Rare Condition ◽  
Artery Dissection ◽  
Review Of Literature ◽  
Surgical Department ◽  
Superior Mesenteric Artery Dissection

Acute abdominal pain is one of the most common conditions encountered in the emergency department. The differential diagnosis of acute abdominal pain is extensive and identifying the underlying etiology can be challenging. We report a case of acute transient ischemic jejunitis due to symptomatic isolated superior mesenteric artery dissection in a patient with no cardiovascular risk factors or autoimmune diseases. Symptomatic isolated superior mesenteric artery dissection is a rare cause of acute abdominal pain usually treated in the surgical department. The patient had criteria for conservative treatment and rapidly recovered. We highlight a rare condition which should be taken into account for the differential diagnosis of acute abdominal pain.

scholarly journals Epigastric Pain and Weight Loss – A Case of Wilkie’s Syndrome

2020 ◽  
Author(s):  
Ana Lima Silva ◽  
Daniela Antunes ◽  
Joana Cordeiro Cunha ◽  
Renato Nogueira ◽  
Diana Fernandes ◽  
...  
Keyword(s):  
Weight Loss ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Epigastric Pain ◽  
Gastrointestinal Symptoms ◽  
Laboratory Findings ◽  
Wilkie’S Syndrome ◽  
Sma Syndrome ◽  
Computed Tomography Enterography ◽  
History Of

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. Physical and laboratory findings are often non-specific but imaging methods are useful for diagnosing the condition. A 46-year-old female patient presented to the outpatient clinic of our internal medicine department with a 2-year history of epigastric pain, nausea, early satiety and weight loss of 15 kg. Previous studies were inconclusive. The patient underwent computed tomography enterography and its findings were consistent with SMA syndrome. Currently the patient is being followed by General Surgery and Nutrition and is under nutritional measures in order to optimize her body mass index to decrease possible surgical complications.This case report emphasizes the importance of clinical suspicion and careful investigation when considering less common etiologies for frequent gastrointestinal symptoms.

scholarly journals Laparoscopic Hand-Sewn Duodenojejunostomy for Superior Mesenteric Artery Syndrome Using 3D-4K Image - A Case Study

2022 ◽  
Vol 40 (1) ◽  
pp. 68-71
Author(s):  
Md Jahangir Hossan Bhuiyan ◽  
Farhana Begum ◽  
Mohammad Anwar Hossain
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Duodenal Obstruction ◽  
Intraoperative Complications ◽  
Rare Condition ◽  
Cost Effective ◽  
Vascular Compression ◽  
Invasive Approach ◽  
Intracorporeal Suturing ◽  
Sma Syndrome

Background: Superior mesenteric artery (SMA) syndrome, also known as wilkie’s syndrome, is a rare condition characterized by vascular compression of third part of the duodenum that leads to duodenal obstruction. Traditionally, open or laparoscopic stapled duodenojejunostomy is recommended when conservative management failed. We report a 3D-4K image hand-sewn duodenojejunostomy (DJ) for the treatment of SMA syndrome. Materials and Methods: A 13 years old patient presented with anorexia, post prandial vomiting, dull abdominal pain & weight loss for 6 years. Upper GI endoscopy revealed duodenal stenosis and Barium follow through demonstrated obstruction to the third part of the duodenum. Ultrasound examination revealed gastric & duodenal dilatation. With these clinical and radiological findings, the diagnosis of SMA syndrome was suspected. He was identified as a candidate for a duodenojejunostomy. 3D-4K image system was used for superior image quality and binocular depth perception and a laparoscopic hand-sewn duodenojejunostomy performed on september 20, 2020 Results: Diagnostic laparoscopy detected SMA syndrome. Laparoscopic hand-sewn duodenojejunostomy took 120 minutes time. There were no intraoperative complications. The blood loss was minimum. The postoperative course was uneventful with resolution of duodenal obstruction. The patient discharged on 6th postoperative day. He gained 10 kg weight 6weeks after surgery. Conclusion: 3D-4K image laparoscopic hand-sewn duodenojejunostomy as a surgical option for the treatment of SMA syndrome is safe, cost effective, feasible, and valid alternative to open and laparoscopic stapled technique with added benefits of a minimally invasive approach. Additionally hand-sewn anastomosis ensures good tissue approximation. Of course it is time consuming and needs expertise in intracorporeal suturing. 3D-4K image technology makes this difficult procedure easier. J Bangladesh Coll Phys Surg 2022; 40: 68-71

scholarly journals Superior Mesenteric Artery Syndrome Associated with Rapid Weight Loss Attributed to Amphetamine Abuse

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Richard M. Fazio ◽  
On Chen ◽  
Wael Eldarawy
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Female Patient ◽  
Mesenteric Artery ◽  
Rapid Weight Loss ◽  
Amphetamine Abuse ◽  
The Third ◽  
Sma Syndrome ◽  
Number Of Factors

Superior mesenteric artery (SMA) syndrome arises from a reduction in the angle formed between the SMA and the aorta, thereby compressing the third portion of the duodenum. This phenomenon may be caused by a number of factors, one of which being acute weight loss. We report a case of a female patient presenting with abdominal pain and vomiting who developed superior mesenteric artery (SMA) syndrome as a result of rapid weight loss, thought to be secondary to amphetamine abuse. This association can often be overlooked and, to our knowledge, has not been previously reported.

Superior Mesenteric Artery Syndrome in Children

2001 ◽  
Vol 46 (5) ◽  
pp. 153-154 ◽  
Author(s):  
G.V.S. Murthi ◽  
P.A.M. Raine
Keyword(s):  
Weight Loss ◽  
Superior Mesenteric Artery ◽  
Spinal Surgery ◽  
Mesenteric Artery ◽  
Barium Meal ◽  
Superior Mesenteric Artery Syndrome ◽  
Ligament Of Treitz ◽  
Clinical Associations ◽  
Upper Gastrointestinal ◽  
Clinical Problems

Superior mesenteric artery syndrome is an uncommon clinical condition characterised by features of acute or chronic upper gastrointestinal tract obstruction. It sometimes has particular clinical associations such as weight loss, spinal surgery cast application or adhesions. Associated multiple clinical problems can complicate the picture and delay diagnosis. Diagnosis is usually by barium meal showing compression of the 3rd part of duodenum. Treatment can be conservative or surgical. Surgical treatment consists of division of the ligament of Treitz and derotation of the gut. We review our experience of four children with this syndrome.

Synchronous celiac axis and superior mesenteric artery embolism

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 495-498 ◽  
Author(s):  
Rajkovic ◽  
Zelic ◽  
Papes ◽  
Cizmek ◽  
Arslani
Keyword(s):  
Atrial Fibrillation ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Ct Scan ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Abdominal Cavity ◽  
Celiac Axis ◽  
Contrast Administration ◽  
Artery Embolism

We present a case of combined celiac axis and superior mesenteric artery embolism in a 70-year-old patient that was examined in emergency department for atrial fibrillation and diffuse abdominal pain. Standard abdominal x-ray showed air in the portal vein. CT scan with contrast showed air in the lumen of the stomach and small intestine, bowel distension with wall thickening, and a free gallstone in the abdominal cavity. Massive embolism of both celiac axis and superior mesenteric artery was seen after contrast administration. On laparotomy, complete necrosis of the liver, spleen, stomach and small intestine was found. Gallbladder was gangrenous and perforated, and the gallstone had migrated into the abdominal cavity. We found free air that crackled on palpation of the veins of the gastric surface. The patient’s condition was incurable and she died of multiple organ failure a few hours after surgery. Acute visceral thromboembolism should always be excluded first if a combination of atrial fibrillation and abdominal pain exists. Determining the serum levels of d-dimers and lactate, combined with CT scan with contrast administration can, in most cases, confirm the diagnosis and lead to faster surgical intervention. It is crucial to act early on clinical suspicion and not to wait for the development of hard evidence.

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