Superior mesenteric artery syndrome | |
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Other names | Wilkie syndrome, mesenteric root syndrome, chronic duodenum ileus, Cast syndrome, arteriomesenteric duodenal obstruction[1] |
Abdominal and pelvic computed tomography scan showing duodenal compression (black arrow) by the superior mesenteric artery (red arrow) and the abdominal aorta (blue arrow). | |
Specialty | Gastroenterology, general surgery |
Symptoms | Abdominal pain, fullness, nausea, vomiting, weight loss[2] |
Complications | Small bowel obstruction, pneumatosis intestinalis[2] |
Risk factors | Significant weight loss, surgery for scoliosis, genetics[2] |
Diagnostic method | Based on symptoms and medical imaging after other potential causes are excluded[2] |
Differential diagnosis | Anorexia, bulimia, peptic ulcer disease, irritable bowel syndrome, other causes of gastroparesis[1] |
Treatment | Gaining weight, sitting with the knees to the chest after eating, surgery[2] |
Frequency | 2 per 1,000 people[1] |
Superior mesenteric artery (SMA) syndrome is a digestive condition that occurs when the first part of the small intestine (duodenum) is compressed between two arteries (the aorta and the superior mesenteric artery).[2] Symptoms may include abdominal pain, rapid fullness when eating, nausea, vomiting, and weight loss.[2] Complications may include small bowel obstruction, electrolyte abnormalities, and pneumatosis intestinalis.[2]
Causes may include significant weight loss or following surgery for scoliosis.[2] Cases may run in families.[2] The underlying mechanism often involves the loss of the fatty tissue that surrounds the superior mesenteric artery.[2] Diagnosis is generally based on symptoms and medical imaging after other potential causes are excluded.[2] Nutcracker syndrome is a different condition in which the left renal vein is compressed by an artery.[3]
Treatment may involve gaining weight, sitting with the knees to the chest after eating, or surgery.[2] Small and frequent meals may be helpful.[2] Tube feeding or intravenous nutritional support may be required in severe cases.[2] Metoclopramide may be used to help with nausea.[2] Surgery is generally only considered if other measures are not effected.[2] SMA is estimated to affect about 2 per 1,000 people.[1] It was first described in 1861 by Carl von Rokitansky.[4]