Superior mesenteric artery syndrome:Diagnosis and management  

作　　者：Akihiko Oka Muyiwa Awoniyi Nobuaki Hasegawa Yuri Yoshida Hiroshi Tobita Norihisa Ishimura Shunji Ishihara 

机构地区：[1]Department of Internal Medicine Ⅱ,Shimane University Faculty of Medicine,Izumo 693-8501,Shimane,Japan [2]Department of Gastroenterology,Hepatology and Nutrition,Digestive Disease and Surgery Institute,Hepatology Section,Cleveland Clinic,Cleveland,OH 44195,United States [3]Clinical Laboratory Division,Shimane University Hospital,Izumo 693-8501,Shimane,Japan [4]Division of Hepatology,Shimane University Hospital,Izumo 693-8501,Shimane,Japan

出　　处：《World Journal of Clinical Cases》2023年第15期3369-3384,共16页世界临床病例杂志

摘　　要：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(i.e.,laparoscopic duodenojejunostomy)is recommended(success rates:80%-100%).

关 键 词：Superior mesenteric artery syndrome Wilkie’s syndrome Cast syndrome Aorto-mesenteric compass syndrome 

分 类 号：R572.3[医药卫生—消化系统]