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      Superior Mesenteric Artery Syndrome: A Case Report and Literatures Review

      Author(s): , , ,
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      Journal: Journal of Translational Critical Care Medicine
      Publisher: Ovid Technologies (Wolters Kluwer Health)

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          ABSTRACT

          Superior mesenteric artery syndrome (SMAS) is a rare clinical disease caused by obstruction of the duodenum at the angle between the abdominal aorta and superior mesenteric artery. We report a male patient admitted to our hospital with a chief complaint of obvious postprandial vomiting and nausea. SMAS was confirmed by abdominal computed tomography images and clinical symptoms. After admission, the patient was treated with fasting, antibiotics, fluid resuscitation, parenteral nutrition, and other conservative treatments. However, the patient deteriorated rapidly and died because of multiple organ failure. SMAS is easily missed, which may delay timely treatment. Clinicians should improve their clinical understanding of SMAS.

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          The SCARE 2020 Guideline: Updating Consensus Surgical CAse REport (SCARE) Guidelines

          Riaz Agha, Thomas Franchi, Catrin Sohrabi … (2020)
          The SCARE Guidelines were first published in 2016 and were last updated in 2018. They provide a structure for reporting surgical case reports and are used and endorsed by authors, journal editors and reviewers, in order to increase robustness and transparency in reporting surgical cases. They must be kept up to date in order to drive forwards reporting quality. As such, we have updated these guidelines via a DELPHI consensus exercise.
          Article 0 comments Cited 4681 times – based on 0 reviews     Review now
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            Superior mesenteric artery syndrome: diagnosis and treatment strategies.

            S Biankin, R. Wilson, P H Cosman … (2009)
            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. A series of eight cases is presented reviewing the presentation, investigations, surgical treatment by division of duodenum and duodenojejunostomy, and outcomes. 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.
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              Superior mesenteric artery syndrome: CT and ultrasonography findings.

              Birsen Unal Daphan, Gökhan Kemal, Cagatay Daphan … (2005)
              The purpose of the study was to describe computed tomography (CT) and ultrasonography findings in superior mesenteric artery syndrome (SMAS). The study was performed on 89 CT examinations. Ultrasonography was performed on 32 and barium study was performed on four of these subjects. Group A consisted of cases with one or more of the following complaints: postprandial epigastric pain, weight loss and vomiting. Group B consisted of the remaining cases. Cases who had all of the above-mentioned clinical findings and duodenal dilatation, to-and-fro barium movement and SMA indentation in barium study were diagnosed as having SMAS. Body mass index (BMI, kg/m2) was calculated. The distance between SMA and aorta, at the location where the duodenum passes from, was measured on CT and ultrasonography. The angle between SMA and aorta was measured on ultrasonography images. Group and gender differences were analyzed with t-test, the relationship between clinical and CT findings was analyzed with Mann Whitney U test and the relations between BMI-CT and CT-ultrasonography measurements were analyzed with Pearson coefficients. Of 13 cases in Group A, 3 were diagnosed as SMAS. Eight of the cases showed gastric and/or duodenal dilatation. In 6 cases, antrum had an abnormally high location at portal hilus. In Group A, the SMA-aorta distance was 6.6 +/- 1.5 mm and the SMA-aorta angle was 18.7 +/- 10.7 degrees . In Group B, these values were 16.0 +/- 5.6 mm and 50.9 +/- 25.4 degrees , respectively (p < 0.001). Cut-off values between SMAS and Group B were 8 mm (100% sensitivity and specificity), and 22 degrees (42.8% sensitivity, 100 % specificity). CT and ultrasonography measurements (p < 0.001) and SMA-aorta distance and BMI (p=0.004) were significantly correlated. The SMA-aorta distance was significantly shorter in females (p=0.036). Gastric and/or duodenal dilatation and a diminished SMA-aorta distance have a significant correlation with clinical symptoms of SMAS that include postprandial pain, vomiting and weight loss.
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                Author and article information

                Contributors
                Journal
                Title: Journal of Translational Critical Care Medicine
                Abbreviated Title: J Transl Crit Care Med
                Publisher: Ovid Technologies (Wolters Kluwer Health)
                ISSN (Print): 2665-9190
                ISSN (Electronic): 2590-3438
                Publication date Created: 2023
                Publication date (Electronic): June 2023
                Publication date (Electronic): April 18 2023
                Volume: 5
                Issue: 2
                Article
                DOI: 10.1097/JTCCM-D-22-00017
                SO-VID: ac6f1d75-8020-4fc7-9916-63c32f23447b
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