scholarly journals Wilkie's Syndrome or Superior Mesenteric Artery Syndrome: Fact or Fantasy

2015 ◽  
Vol 9 (2) ◽  
pp. 194-199 ◽  
Author(s):  
Vera Zaraket ◽  
Liliane Deeb
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Early Recognition ◽  
Fatty Tissue ◽  
Non Invasive ◽  
Wilkie’S Syndrome ◽  
Gastrointestinal Obstruction ◽  
Sma Syndrome ◽  
Upper Gastrointestinal ◽  
High Intestinal Obstruction

Superior mesenteric artery (SMA) syndrome (known as Wilkie's syndrome) is a rare cause of upper gastrointestinal obstruction. It is an acquired disorder in which acute angulation of the SMA causes compression of the third part of the duodenum between the SMA and the aorta. This is commonly due to loss of fatty tissue as a result of a variety of debilitating conditions. We report a 17-year-old female who presented with intermittent abdominal pain and intractable vomiting following significant weight loss after hospitalization for pneumonia. Symptoms persisted for 2 years and the patient underwent extensive invasive and non-invasive tests, but to no avail. Thereafter she developed acute high intestinal obstruction, which unraveled her diagnosis. This case emphasizes the challenges in the diagnosis of SMA syndrome and the need for increased awareness of this entity. This will improve early recognition in order to reduce irrelevant tests and unnecessary treatments.

scholarly journals Facts and fantasies about superior mesenteric artery syndrome: an unusual cause of intestinal obstruction

2019 ◽  
Vol 6 (7) ◽  
pp. 2591
Author(s):  
Swapnil Singh Kushwaha ◽  
Shikha Goja
Keyword(s):  
Intestinal Obstruction ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Early Recognition ◽  
Recurrent Abdominal Pain ◽  
Favourable Outcome ◽  
Vascular Compression ◽  
Fatty Tissue ◽  
Diagnostic Dilemma ◽  
Sma Syndrome

Superior mesenteric artery (SMA) syndrome (also known as Wilkie’s syndrome) is an unusual cause of proximal intestinal obstruction, attributable to vascular compression of the third part of duodenum between the superior mesenteric artery and the abdominal aorta due to acute angulation of SMA. It is a life threatening disease as it poses a diagnostic dilemma and often diagnosed by exclusion of other causes. It is an acquired disorder and is commonly due to loss of fatty tissue as a result of a variety of debilitating conditions. We report a case of SMA syndrome in a 23 year young asthenic female patient, with a long history of recurrent abdominal pain, epigastric fullness, voluminous vomiting, and weight loss. Symptoms persisted for 1 year and the patient underwent extensive investigations, but to no avail. Thereafter she developed proximal intestinal obstruction, which unravelled her diagnosis. Abdominal examination revealed epigastric fullness, tenderness and hyper peristaltic bowel sounds. We performed small bowel enteroclysis, upper gastrointestinal series, abdominal computer-tomography (CT) and ultrasonography to establish the diagnosis. Conservative treatment was tried for one month but failed. There was no relief of symptoms in the left lateral decubitus or prone position. Finally, the patient successfully underwent Roux-en-Y duodenojejunal anastomosis with a postoperative favourable outcome. This case emphasizes the challenges in the diagnosis of SMA syndrome and the need for increased awareness of this entity. This will improve early recognition in order to reduce irrelevant tests and unnecessary treatments.

scholarly journals Case Report of a Superior Mesenteric Artery Syndrome in an Autistic Patient with Schizophrenia

2021 ◽  
pp. 21
Author(s):  
Lee Mem Tim ◽  
Bernard Ho Kar Eng ◽  
Sentilnathan Subramaniam ◽  
Harivinthan Sellappan
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Ct Scan ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Superior Mesenteric Artery Syndrome ◽  
Autistic Patient ◽  
Gastrointestinal Obstruction ◽  
Sma Syndrome ◽  
Upper Gastrointestinal

Introduction: Superior mesenteric artery (SMA) syndrome is a rare cause of upper gastrointestinal obstruction. Diagnosis is confirmed via computed tomography (CT) scan showing acute angulation at the origin of superior mesenteric artery compressing on the duodenum causing proximal dilatation of the second part of duodenum.

scholarly journals Wilkie’s Syndrome: Case Report

2020 ◽  
pp. 1-2
Author(s):  
Vladimir Schraibman ◽  
Vladimir Schraibman ◽  
Marina Epstein ◽  
Gabriel Maccapani ◽  
Franco Milan Sapuppo ◽  
...  
Keyword(s):  
Weight Loss ◽  
Case Report ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Treatment Options ◽  
Diagnostic Study ◽  
Postprandial Fullness ◽  
Wilkie’S Syndrome ◽  
Gastrointestinal Obstruction ◽  
Upper Gastrointestinal

Superior mesenteric artery (SMA) syndrome (known as Wilkie's syndrome) is a rare cause of upper gastrointestinal obstruction. A 34-year-old woman presented with nonspecific symptoms of postprandial fullness and important weight loss. After screening for other pathologies, it was diagnosed Wilkie’s syndrome. Within this case it was briefly reviewed the diagnostic study and treatment options including a description of the selected approach, a robotic duodenojejunostomy.

scholarly journals Acute Kidney Injury Caused by Superior Mesenteric Artery Syndrome

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Nur Ezzaty Mohammad Kazmin ◽  
Lydia Kamaruzaman ◽  
Zhiqin Wong ◽  
Voon Ken Fong ◽  
Rozita Mohd ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Metabolic Alkalosis ◽  
Tube Feeding ◽  
Kidney Injury ◽  
Successful Resuscitation ◽  
Gastrointestinal Obstruction ◽  
Sma Syndrome ◽  
Upper Gastrointestinal

Background. Superior mesenteric artery (SMA) syndrome is a rare cause of upper gastrointestinal obstruction leading to acute kidney injury (AKI). Methods. We report a case of 23-year-old army personnel who presented with persistent vomiting leading to severe hypokalaemia, metabolic alkalosis, and acute kidney injury resulting in cardiorespiratory arrest. Results. After successful resuscitation, he was supported with haemodialysis and aggressive electrolytes correction. He was repeatedly not able to tolerate nasogastric (NG) tube feeding and computerised tomography of abdomen was performed, and the diagnosis of SMA syndrome was made. Gastroscopy examination revealed duodenal ulcer at D1, pinhole D1-D2 junction, but there was no evidence of intraluminal mass or lesions leading to upper gastrointestinal obstruction. A nasojejunal tube was inserted to bypass the narrow segment of the duodenum, and he was put on nutritional support. He was subsequently weaned off dialysis support as his renal function gradually improved and later on normalised. He remains symptoms free, and he gained five kilograms in four months after discharge. Conclusions. SMA syndrome is a rare cause of upper gastrointestinal obstruction but should be considered as a differential diagnosis in a patient who presented with recurrent vomiting and AKI with metabolic alkalosis.

scholarly journals Superior mesenteric artery syndrome: a rare case of upper gastrointestinal obstruction

2019 ◽  
Vol 2019 (3) ◽  
Author(s):  
Dimosthenis Chrysikos ◽  
Theodore Troupis ◽  
John Tsiaoussis ◽  
Markos Sgantzos ◽  
Vasileios Bonatsos ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Rare Case ◽  
Superior Mesenteric Artery Syndrome ◽  
Gastrointestinal Obstruction ◽  
Upper Gastrointestinal

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 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.

Superior mesenteric artery (Wilkie’s) syndrome: a rare cause of upper gastrointestinal system obstruction

2016 ◽  
Vol 116 (2) ◽  
pp. 81-88 ◽  
Author(s):  
Abdullah Oguz ◽  
Omer Uslukaya ◽  
Burak Veli Ülger ◽  
Ahmet Turkoglu ◽  
Mehmet Veysi Bahadır ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Gastrointestinal System ◽  
Wilkie’S Syndrome ◽  
Upper Gastrointestinal

scholarly journals Wilkie’s syndrome. Analysis of 150 cases of the Iberian and Ibero-American medical literature

2020 ◽  
Vol 61 (3) ◽  
pp. 242-264
Author(s):  
Ezequiel Trejo Scorza ◽  
Oscar Luis Colina Cedeño ◽  
Edgar José Brito Arreaza ◽  
Carlos José Trejo Scorza
Keyword(s):  
Surgical Treatment ◽  
Computed Tomographic ◽  
Wilkie’S Syndrome ◽  
Gastrointestinal Obstruction ◽  
Horizontal Part ◽  
Horizontal Portion ◽  
American Authors ◽  
Upper Gastrointestinal ◽  
Syndrome Analysis ◽  
High Intestinal Obstruction

Willkie’s syndrome or superior mesenteric artery (SMA) syndrome is a rare cause of gastrointestinal obstruction, due to exterior compression of the horizontal part of the duodenum by the SMA. For the study of the clinical, diagnostic and therapeutic characteristics of Wilkie’s syndrome in the Iberian and Ibero-American population, we compiled the reports of 150 cases by Iberican and Ibero-American authors, and we found a predominance of cases in females over males in a ratio of 2.57: 1. Fifty percent of the cases were in patients under 20-years of age, with the highest number of cases in schoolchildren and adolescents. The most frequent symptoms were abdominal pain, vomiting and weight loss. The disease had two forms of presentation: acute with signs of high intestinal obstruction (16.47%), and chronic (83.53%). Diagnostic radiographic studies showed in of the upper gastrointestinal tract narrowing of the horizontal portion of the duodenum and delay in the transit of contrast through the gastroduodenal region, with or without gastroduodenal dilation in 85% of cases. In computed tomographic studies it was observed decreased mesenteric-aortic angle and distance. Upper endoscopic studies showed narrowing of the horizontal part of the duodenum, with or without gastroduodenal dilation in 61.90% of cases. Of the 144 patients that received treatment, 94 cases received medical treatment, with a success rate of 62.77%; and 84 cases required surgical treatment, 59.52% of these, upon admission. The most practiced surgical procedure was laterolateral duodenojejunostomy in 70.24% of cases. We concluded that Wilkie’s syndrome is an entity that results from the reduction of the mesenteric-aortic angle and distance, with two forms of presentation: acute and chronic, that required surgical treatment in 58.33% of cases.

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