Superior Mesentric Artery Syndrome

Superior Mesentric Artery Syndrome


Superior Mesenteric Artery syndrome or Wilkie’s syndrome

  • Superior mesenteric artery syndrome is a rare condition in which obstruction of the 3rd portion of duodenum is produced by compression between the superior mesenteric vessels and the aorta.

Causes and pathophysiology

  • The superior mesenteric artery normally leaves the aorta at an acute angle (-50-60°). Normally a mass of fat and lymphatics around the origin of SMA is believed to protect the duodenum from compression.
  • Factors that may precipitate obstruction are-
  1. Sudden weight loss following injury or bum
  2. Rapid growth in height
  3. Application of body casts
  4. Supine immobilization

Clinical features

  • The syndrome is seen in thin patients.
  • Common in young adults, more common in females
  • Symptoms include epigastric bloating and crampy pain after meals, relieved by vomiting or prone position.

Investigation

  • Barium meal study
  • Hypotonic duodenography is superior to barium meal
  • CT scan with contrast

Management

  • Conservative t/t
  • Conservative t/t is successful in most cases associated with orthopedic condition. Treatment usually involves removal of plaster cast and mobilization of patient.
  • Postural therapy : patient is advised to turn into prone or knee-elbow position after meals or when symptomatic.
  • Surgery for patients not responding to conservative methods
  • Duodenojejunostomy is done

Exam Important

Causes and pathophysiology

  • The superior mesenteric artery normally leaves the aorta at an acute angle (-50-60°). Normally a mass of fat and lymphatics around the origin of SMA is believed to protect the duodenum from compression.
  • Factors that may precipitate obstruction are-
  1. Sudden weight loss following injury or bum
  2. Rapid growth in height
  3. Application of body casts
  4. Supine immobilization

Clinical features

  • The syndrome is seen in thin patients.
  • Common in young adults, more common in females
  • Symptoms include epigastric bloating and crampy pain after meals, relieved by vomiting or prone position.
Don’t Forget to Solve all the previous Year Question asked on Superior Mesentric Artery Syndrome

Module Below Start Quiz

Leave a Reply

Free Mini Course on Stomach

Mini Course – Stomach

22 High Yield Topics in Stomach

in Just 2 Hours

Submission received, thank you!

Close Window
%d bloggers like this:
Malcare WordPress Security