Superior mesenteric artery syndrome

Superior mesenteric artery syndrome Enteric infections Inflammatory bowel diseases Pancreatitis Appendicitis Cholecystitis Biliary colic Gastroparesis Postvagotomy syndrome Intestinal pseudo-obstruction Functional dyspepsia Gastroesophageal reflux Peptic ulcer disease Hepatitis Peritonitis Gastric malignancy Liver failure... 

Nicolaou S, Kai B, Ho S et al (2005) Imaging of acute small bowel obstruction. AJR Am J Roentgenol 185 1036-1044 (review) Ortiz C, Cleveland RH, Blickman JG, Jaramillo D, Kim SH (1990) Familial superior mesenteric artery syndrome. Pediatr Radiol 20 588-589... 

There were six children who could not eat during their therapy. This included two patients who had superior mesenteric artery syndromes demonstrated by cine-radiography, and four children with duodenal ulcers demonstrated on upper gastrointestinal X-rays. Five of these children survived, and their parenteral nutrition was considered life-saving. The sixth patient required a surgical repair of her duodenal ulcer and died in terminal sepsis after a weight loss of 15.77o. 

Superior mesenteric artery (SMA) syndrome is an uncommon but well recognized clinical entity characterized by compression of the third, or transverse, portion of the duodenum against the aorta by the SMA, resulting in chronic, intermittent or acute complete or partial duodenal obstruction. Clinical symptoms are chronic upper abdominal symptoms such as epigastric pain, nausea, vomiting (bilious or partially digested food), postprandial discomfort and sometimes subacute small bowel obstruction. The stomach can be massively dilated and perforation has been described (Carty et al. 2005 Parker 2003). 

Fig.4.7a,b. Afferent loop syndrome, a Supine abdominal radiograph shows virtually absent bowel gas because of frequent vomiting, b Sagittal color Doppler sonogram of the upper abdomen shows the dilated third part of the duodenum (D3) anterior to the abdominal aorta and posterior to the superior mesenteric artery (arrows)... 

Some authors suggest that renal vein obstruction is a common etiology of ovarian vein reflux. This does not reflect the author s experience. A Belgian study of 48 patients with pelvic congestion syndrome found that 83% had extrinsic compression of the left renal vein between the aorta and the superior mesenteric artery resulting in the nutcracker phenom-... 

Fig. 7.33a,b. Contrast-enhanced MDCT obtained 4 months after operation in 5-year-old girl with short-bowel syndrome after intestinal transplantation. (Ao abdominal aorta, C colon, CIA common iliac artery, d donor, D duodenum, I ileum, IMA inferior mesenteric artery, IVC inferior vena cava, / jejunum, r recipient, SMV superior mesenteric vein.) Annotations intestinal graft lumen white asterisk), subsegmental arteries and veins in mesenteric fat of intestinal graft arrow), donor lymph node black arrowhead), proximal intestinal anastomosis between white arrowheads), distal intestinal anastomosis between white arrows). a, b Images show (a) proximal intestinal end-to-end anastomosis between white arrowheads) between recipient duodenum and donor jejunum as well as (b) distal intestinal end-to-end anastomosis between white arrows) marked by hyperdense staple line between donor ileum and recipient ascending colon... 

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