Superior mesenteric artery syndrome: Diagnosis and management

被引:31
作者
Oka, Akihiko [1 ]
Awoniyi, Muyiwa [2 ]
Hasegawa, Nobuaki [1 ]
Yoshida, Yuri [3 ]
Tobita, Hiroshi [4 ]
Ishimura, Norihisa [1 ]
Ishihara, Shunji [1 ]
机构
[1] Shimane Univ, Fac Med, Dept Internal Med 2, Izumo, Shimane 6938501, Japan
[2] Cleveland Clin, Digest Dis & Surg Inst, Dept Gastroenterol Hepatol & Nutr, Hepatol Sect, Cleveland, OH 44195, Albania
[3] Shimane Univ Hosp, Clin Lab Div, Izumo, Shimane 6938501, Japan
[4] Shimane Univ Hosp, Div Hepatol, Izumo, Shimane 6938501, Japan
关键词
Superior mesenteric artery syndrome; Wilkie's syndrome; Cast syndrome; Aorto-mesenteric compass syndrome; MASSIVE GASTRIC DILATATION; HENOCH-SCHONLEIN PURPURA; ABDOMINAL-PAIN; VASCULAR COMPRESSION; DUODENAL INVOLVEMENT; SCOLIOSIS SURGERY; WILKIES SYNDROME; RISK INDICATORS; CHILDREN; OBSTRUCTION;
D O I
10.12998/wjcc.v11.i15.3369
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Superior mesenteric artery (SMA) syndrome (also known as Wilkie's syndrome, cast syndrome, or aorto-mesenteric compass syndrome) is an obstruction of the duodenum caused by extrinsic compression between the SMA and the aorta. The median age of patients is 23 years old (range 0-91 years old) and predominant in females over males with a ratio of 3:2. The symptoms are variable, consisting of postprandial abdominal pain, nausea and vomiting, early satiety, anorexia, and weight loss and can mimic anorexia nervosa or functional dyspepsia. Because recurrent vomiting leads to aspiration pneumonia or respiratory depression via metabolic alkalosis, early diagnosis is required. The useful diagnostic modalities are computed tomography as a standard tool and ultrasonography, which has advantages in safety and capability of real-time assessments of SMA mobility and duodenum passage. The initial treatment is usually conservative, including postural change, gastroduodenal decompression, and nutrient management (success rates: 70%-80%). If conservative therapy fails, surgical treatment (i.e., laparoscopic duodenojejunostomy) is recommended (success rates: 80%-100%).
引用
收藏
页码:3369 / 3384
页数:16
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