A forgotten disease: Superior mesenteric artery syndrome

Journal of Clinical and Analytical Medicine Pub Date : 2019-05-01 DOI:10.4328/JCAM.5902

A. Kefeli

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Abstract

DOI: 10.4328/JCAM.5902 Received: 12.05.2018 Accepted: 09.06.2018 Published Online: 10.06.2018 Printed: 01.05.2019 J Clin Anal Med 2019;10(3): 334-8 Corresponding Author: Ayse Kefeli, Gastroenterology Department, Gaziosmanpaşa University, Tokat, Turkey. GSM: +905054506997 E-Mail: aysekefeli@hotmail.com ORCID ID: 0000-0002-1876-2586 Abstract Aim: Superior mesenteric artery syndrome (SMAS) is a rare cause of upper gastrointestinal obstruction. As it is encountered infrequently, there have been only a few studies on it, mostly in the form of case series or just a case presentation in the literature. In this study, we aim to investigate common clinical features and radiological measurements between patients admitted with symptoms of gastric outlet obstruction due to SMAS and those without SMAS. Material and Method: This study was conducted prospectively on individuals admitted to our clinic presenting with symptoms of gastric outlet obstruction in the previous six months and who had undergone computerized tomography. (Here, SMAS is defined by a narrow aortomesenteric angle and a short aortomesenteric distance.) Demographic features and radiological measurements were compared between patients with and without SMAS. The results of a three-month follow-up of each subject with SMAS were recorded. Results: This study includes a total of 92 subjects, 14 (15%) of whom had a diagnosis of SMAS (Group 1) and 78 (85%) of whom did not (Group 2). Group 1 had a predominance of female and significantly younger patients (mean age: 31.1 ± 10.2), compared to Group 2 (mean age: 44 ± 11.7) (p < 0.001). Abdominal subcutaneous fat tissue thickness was thinner in group 1 than in group 2 (18.1 ± 8.1 and 23.7 ± 12.2, respectively; p = 0.039). Eleven of the 14 SMAS patients (78.5%) recovered with medical treatment, but in the other three cases, surgical intervention was considered. Discussion: SMAS is an important and preventable cause of small bowel obstruction. Although it is a rare condition in the general population, accurate diagnosis of the disease leads to improvement of symptoms; simple medical management can preclude the need for surgery.

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一种被遗忘的疾病：肠系膜上动脉综合征

DOI: 10.4328 / JCAM.5902收稿日期:12.05.2018收稿日期:09.06.2018出版日期:10.06.2018印刷日期:01.05.2019 J clinical Anal Med 2019;10(3): 334-8通讯作者:Ayse Kefeli，土耳其Tokat gaziosmanpa大学消化内科。摘要目的:肠系膜上动脉综合征(SMAS)是一种罕见的上消化道梗阻原因。由于不常见，对其的研究很少，大多以病例系列或文献中的病例介绍的形式进行。在这项研究中，我们的目的是探讨有SMAS引起的胃出口梗阻症状的患者和没有SMAS的患者的共同临床特征和放射学测量。材料和方法:本研究是前瞻性的，研究对象是在过去6个月内以胃出口梗阻症状就诊并接受过计算机断层扫描的患者。(此处，SMAS的定义是主动脉肠系膜角度窄，主动脉肠系膜距离短。)比较SMAS患者和非SMAS患者的人口学特征和放射学测量。记录每个患有SMAS的受试者三个月的随访结果。结果:本研究共纳入92例受试者，其中14例(15%)被诊断为SMAS(第1组)，78例(85%)未被诊断为SMAS(第2组)。与第2组(平均年龄44±11.7)相比，第1组以女性和明显年轻的患者为主(平均年龄31.1±10.2)(p < 0.001)。腹腔皮下脂肪组织厚度1组明显小于2组(分别为18.1±8.1和23.7±12.2);P = 0.039)。14例SMAS患者中有11例(78.5%)经药物治疗后恢复，其余3例考虑手术治疗。讨论:小肠梗阻是一个重要的和可预防的原因。虽然它在一般人群中是一种罕见的疾病，但准确的诊断可以改善症状;简单的医疗处理可以避免手术的需要。

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Journal of Clinical and Analytical Medicine MEDICINE, GENERAL & INTERNAL-

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期刊介绍： The Annals of Clinical and Analytical Medicine is an international open-access journal containing peer-reviewed high-quality articles on clinical medicine in the areas of all research study types, reviews, and case reports. Our journal has become an important platform with the help of language support services, which make it easier for writers who have English as their second language to share their clinical experiences with the world.