Superior Mesenteric Artery Syndrome: Diagnosis and Management

Overview

Journal World J Clin Cases

Publisher Baishideng Publishing Group

Specialty General Medicine

Date 2023 Jun 29

PMID 37383896

Authors

Akihiko Oka

Muyiwa Awoniyi

Nobuaki Hasegawa

Yuri Yoshida

Hiroshi Tobita

Norihisa Ishimura

Shunji Ishihara

Affiliations

Soon will be listed here.

Abstract

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 (., laparoscopic duodenojejunostomy) is recommended (success rates: 80%-100%).

Citing Articles

A Two-for-One Diagnosis: A Rare Case of Chronic Abdominal Pain Caused by Gastroptosis and Wilkie's Syndrome in a Young Woman.

Youssoufi N, Jaafari A, Mansour S, El Hamdi M, Gallerani A, Pierrakos C Diagnostics (Basel). 2025; 15(3).

PMID: 39941200 PMC: 11817981. DOI: 10.3390/diagnostics15030270.

Approach to Meal-Related Nausea and Vomiting.

Cangemi D, Chase R, Lacy B Gastroenterol Hepatol (N Y). 2025; 21(1):19-27.

PMID: 39897340 PMC: 11784569.

Double trouble: A case report of concurrent superior mesenteric artery syndrome and nutcracker syndrome in a previously healthy young adult.

Boroomand-Saboor M, Moradi H Int J Surg Case Rep. 2025; 127:110968.

PMID: 39893965 PMC: 11836474. DOI: 10.1016/j.ijscr.2025.110968.

Superior mesenteric artery syndrome in a pediatric patient: A rare case report and literature review.

Haloui N, Guelmami H, Omry A, Ferjaoui W, Behi H, Khalifa M Int J Surg Case Rep. 2025; 127:110861.

PMID: 39813981 PMC: 11782864. DOI: 10.1016/j.ijscr.2025.110861.

Partial intestinal obstruction caused by duodenal obstruction by the superior mesenteric artery and abdominal aorta in a middle-aged woman: A case report.

Zhang X, Sun W, Yao M, Xia Q, Zhang Q, Guo S Heliyon. 2025; 11(1):e41371.

PMID: 39811284 PMC: 11731569. DOI: 10.1016/j.heliyon.2024.e41371.

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