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.

scholarly journals Superior mesenteric artery syndrome: a single centre experience of laparoscopic duodenojejunostomy as the operation of choice

2017 ◽  
Vol 99 (6) ◽  
pp. 472-475 ◽  
Author(s):  
GC Kirby ◽  
ER Faulconer ◽  
SJ Robinson ◽  
A Perry ◽  
R Downing
Keyword(s):  
Weight Loss ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Epigastric Pain ◽  
Superior Mesenteric Artery Syndrome ◽  
Team Approach ◽  
The Third ◽  
Wilkie’S Syndrome ◽  
Sma Syndrome ◽  
Open Gastrojejunostomy

INTRODUCTION The superior mesenteric artery (SMA) syndrome, or Wilkie’s syndrome, is a rare cause of postprandial epigastric pain, vomiting and weight loss caused by compression of the third part of the duodenum as it passes beneath the proximal superior mesenteric artery. The syndrome may be precipitated by sudden weight loss secondary to other pathologies, such as trauma, malignancy or eating disorders. Diagnosis is confirmed by angiography, which reveals a reduced aorto-SMA angle and distance, and contrast studies showing duodenal obstruction. Conservative management aims to increase intra-abdominal fat by dietary manipulation and thereby increase the angle between the SMA and aorta. Where surgery is indicated, division of the ligament of Treitz, anterior transposition of the third part of the duodenum and duodenojejunostomy have been described. METHODS We present four cases of SMA syndrome where the intention of treatment was laparoscopic duodenojejunostomy. The procedure was completed successfully in three patients, who recovered quickly with no short-term complications. A fourth patient underwent open gastrojejunostomy (complicated by an anastomotic bleed) when dense adhesions prevented duodenojejunostomy. CONCLUSIONS The superior mesenteric artery syndrome should be considered in patients with epigastric pain, prolonged vomiting and weight loss. Laparoscopic duodenojejunostomy is a safe and effective operation for management of the syndrome. A multi-speciality team approach including gastrointestinal, vascular and radiological specialists should be invoked in the management of these patients.

scholarly journals Superior Mesenteric Artery Syndrome in a Patient with Cerebral Palsy

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Adi Neuman ◽  
Bhavita Desai ◽  
Daniel Glass ◽  
Wassim Diab
Keyword(s):  
Weight Loss ◽  
Cerebral Palsy ◽  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
High Index ◽  
Superior Mesenteric Artery Syndrome ◽  
The Third ◽  
Abdominal Symptoms ◽  
High Index Of Suspicion

Superior mesenteric artery syndrome involves compression of the third part of the duodenum due to narrowing of the area between the aorta and the superior mesenteric artery (SMA). We will describe the case of a 34-year-old with cerebral palsy who presented with abdominal pain, nausea, vomiting, and weight loss and was diagnosed with SMA syndrome via CT-imaging. With failure of conservative measures, our patient underwent a duodenojejunostomy after which improvement in her weight as well as relief of her abdominal symptoms was noted. Given the rarity of this syndrome, physicians need to keep a high index of suspicion in order to prevent the damaging consequences.

scholarly journals A clinical course of a patient with anorexia nervosa receiving surgery for superior mesenteric artery syndrome

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Ken Kurisu ◽  
Yukari Yamanaka ◽  
Tadahiro Yamazaki ◽  
Ryo Yoneda ◽  
Makoto Otani ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Anorexia Nervosa ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Rare Complication ◽  
Nutrition Therapy ◽  
Psychological Status ◽  
Sma Syndrome

Abstract Background Superior mesenteric artery (SMA) syndrome is a well-known but relatively rare complication of anorexia nervosa. Although several reports have proposed surgery for SMA syndrome associated with anorexia nervosa, these have shown poor outcomes or did not reveal the long-term weight course. Thus, the long-term effectiveness of surgery for SMA syndrome in such cases remains unclear. This case report describes a patient with anorexia nervosa who underwent surgery for SMA syndrome. Case presentation An 18-year-old woman presented with anorexia nervosa when she was 16 years old. She also presented with SMA syndrome, which seemed to be caused by weight loss due to the eating disorder. Nutrition therapy initially improved her body weight, but she ceased treatment. She reported that symptoms related to SMA syndrome had led to her weight loss and desired to undergo surgery. Laparoscopic duodenojejunostomy was performed, but her body weight did not improve after the surgery. The patient eventually received conservative nutritional treatment along with psychological approaches, which led to an improvement in her body weight. Conclusions The case implies that surgery for SMA syndrome in patients with anorexia nervosa is ineffective for long-term weight recovery and that conservative treatment can sufficiently improve body weight; this is consistent with the lack of evidence on the topic and reports on potential complications of surgery. Due to difficulties in assessing psychological status, consultation with specialists on eating disorders is necessary for treating patients with severely low body weight.

scholarly journals Wilkie’s Syndrome Following Weight Loss in a Trauma Patient

2020 ◽  
pp. 1-3
Author(s):  
George Oosthuizen ◽  
George Oosthuizen
Keyword(s):  
Weight Loss ◽  
Trauma Patient ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Treatment Options ◽  
Rare Condition ◽  
Feeding Tube ◽  
Significant Weight Loss ◽  
The Third ◽  
Wilkie’S Syndrome

Wilkie’s syndrome, or superior mesenteric artery syndrome, is a rare condition of duodenal obstruction caused by compression of the superior mesenteric artery on the third part of the duodenum. The diagnosis should be considered in a patient who has experienced significant weight loss and now presents with persistent vomiting, especially if the vomiting occurs with the patient in the supine position and is alleviated by the lateral or prone position. The diagnosis can be confirmed by imaging studies demonstrating compression of the third part of the duodenum, and the main aim of treatment should be to pass a feeding tube beyond the point of obstruction to allow enteral feeding. The condition improves spontaneously with weight gain. Further treatment options include parenteral feeding and operative bypass in select cases. Here we present a case of Wilkie’s syndrome in a trauma patient with significant weight loss, together with a review of the literature on this interesting topic.

scholarly journals Superior Mesenteric Artery Syndrome: Clinical, Endoscopic, and Radiological Findings

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Emanuele Sinagra ◽  
Dario Raimondo ◽  
Domenico Albano ◽  
Valentina Guarnotta ◽  
Melania Blasco ◽  
...  
Keyword(s):  
Weight Loss ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Control Group ◽  
Diagnosis And Management ◽  
Sma Syndrome ◽  
Aortomesenteric Angle ◽  
Cect Scan ◽  
Enhanced Computed Tomography ◽  
Aortomesenteric Distance

Background. The superior mesenteric artery (SMA) syndrome is a rare entity presenting with upper gastrointestinal tract obstruction and weight loss. Studies to determine the optimal methods of diagnosis and treatment are required. Aims and Methods. This study aims at analyzing the clinical presentation, diagnosis, and management of SMA syndrome. Ten cases of SMA syndrome out of 2074 esophagogastroduodenoscopies were suspected. A contrast-enhanced computed tomography (CECT) scan was performed to confirm the diagnosis. After, a gastroenterologist and a nutritionist personalized the therapy. Furthermore, we compared the demographical, clinical, endoscopic, and radiological parameters of these cases with a control group consisting of 10 cases out of 2380 EGDS of initially suspected (but not radiologically confirmed) SMA over a follow-up 2-year period (2015-2016). Results. The prevalence of SMA syndrome was 0.005%. Median age and body mass index were 23.5 years and 21.5 kg/m2, respectively. Symptoms developed between 6 and 24 months. Median aortomesenteric angle and aorta-SMA distance were 22 and 6 mm, respectively. All patients improved on conservative treatment. In our series, a marked (>5 kg) weight loss (p=0.006) and a long-standing presentation (more than six months in 80% of patients) (p=0.002) are significantly related to a diagnosis of confirmed SMA syndrome at CECT after an endoscopic suspicion. A “resembling postprandial distress syndrome dyspepsia” presentation may be helpful to the endoscopist in suspecting a latent SMA syndrome (p=0.02). The narrowing of both the aortomesenteric angle (p=0.001) and the aortomesenteric distance (p<0.001) was significantly associated with the diagnosis of SMA after an endoscopic suspicion; however, the narrowing of the aortomesenteric distance seemed to be more accurate, rather than the narrowing of the aortomesenteric angle. Conclusion. SMA syndrome represents a diagnostic and therapeutic challenge. Our results show the following findings: the importance of the endoscopic suspicion of SMA syndrome; the preponderance of a long-standing and chronic onset; a female preponderance; the importance of the nutritional counseling for the treatment; no need of surgical intervention; and better diagnostic accuracy of the narrowing of the aorta-SMA distance. Larger prospective studies are needed to clarify the best diagnosis and management of the SMA syndrome.

A CASE REPORT : A CASE OF SUPERIOR MESENTERIC ARTERY SYNDROME

2021 ◽  
pp. 7-7
Author(s):  
Madhav Santoki ◽  
Alpesh Amin
Keyword(s):  
Case Report ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Duodenal Obstruction ◽  
Superior Mesenteric Artery Syndrome ◽  
Clinical Entity ◽  
The Third ◽  
Sma Syndrome ◽  
Transverse Portion

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. This results in chronic, intermittent, or acute complete or partial duodenal obstruction. Superior mesenteric artery syndrome was rst described in 1861 by Von Rokitansky, who proposed that its cause was obstruction of the third part of the duodenum as a result of arterio-mesenteric compression. Some studies report the incidence of superior mesenteric artery syndrome to be 0.1- 0.3%.

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 Endoscopic features for early detection of superior mesenteric artery syndrome in children

2021 ◽  
Author(s):  
Jae Young Kim ◽  
Myung Seok Shin ◽  
Sun Ho Lee
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Endoscopic Findings ◽  
The Third ◽  
Upper Gi ◽  
Sma Syndrome ◽  
Luminal Narrowing ◽  
Upper Gi Series ◽  
Air Insufflation ◽  
Bile Lake

Abstract Background Superior mesenteric artery syndrome (SMA) syndrome is a rare cause of duodenal obstruction. Diagnostic delay of SMA syndrome is common due to its rarity and lack of index of clinical suspicion. Present study aims to explore the endoscopic features for early decision to evaluate SMA syndrome in children. Methods In case controlled observation study, we identified three endoscopic findings in enrolled cases like as, finding I: a pulsating band like luminal narrowing of the third part of the duodenum without no expansion over one third during air insufflation for at least 15 seconds, finding II: marked dilatation of the duodenal second part during air insufflation at the duodenal third part, and finding III: bile lake in the stomach. SMA syndrome was confirmed with upper GI series in patients with endoscopic finding I or I plus more. We analyzed positive endoscopic findings related with SMA syndrome. Results Twenty-nine patients consisted of 18 (62.1%) cases with SMA syndrome and 11 (37.9%) cases without SMA syndrome. The 3 most common presenting symptoms were postprandial discomfort, abdominal pain, and early satiety. The initial impressions before endoscopy were functional dyspepsia (37.9%), gastritis or gastric ulcer (31.0%), and SMA syndrome (24.1%). Sixteen patients (55.2%) had the constellation of three endoscopic findings (finding I + II + III). Of them, 72.2% confirmed with SMA syndrome, and 27.3% had no SMA syndrome in upper GI series (P = 0.027). Conclusions Endoscopic examination down to the third part of duodenum can provide a clue making a decision to evaluate SMA syndrome, which includes a feature composed of three findings like as a pulsating band like luminal narrowing of duodenal third part, a marked expansion of duodenal second part, and a bile lake in the stomach.

An uncommon cause of abdominal pain and weight loss: the superior mesenteric artery syndrome

VASA ◽  
2014 ◽  
Vol 43 (2) ◽  
pp. 149-153 ◽  
Author(s):  
Yasemin Gunduz ◽  
Fatih Altintoprak ◽  
Kiyasettin Asil ◽  
Guner Cakmak
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Superior Mesenteric Artery Syndrome
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