SMA syndrome - Revision history

ClaireLewis: Redirected page to Superior mesenteric artery syndrome

2017-01-15T22:58:40Z

Redirected page to Superior mesenteric artery syndrome

← Older revision		Revision as of 22:58, 15 January 2017
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	~~==Background==~~		#REDIRECT[[Superior mesenteric artery syndrome]]
	*Full name: [[~~Superior Mesenteric Artery Syndrome]]~~
	**AKA: Wilke's syndrome
	*Rare condition
	*1st described by Von Rokitansky in 1861 and then further studied in detail by Wilke in 1912
	*Occurs when the duodenum is compressed between the aorta and the superior mesenteric artery, level of the third portion of the duodenum
	*Can lead to chronic intermittent or acute, partial or complete gastrointestinal obstruction at the level of the duodenum
	*Controversy over this diagnosis

	~~==Etiology==~~
	*SMA takes off from the abdominal aorta surrounded by fatty and lymphatic tissue also known as the mesenteric pad
	*The mesenteric pad helps the SMA form an angle of about 45 degrees with the abdominal aorta
	*Third part of the duodenum courses between the angle formed
	*Narrowing of this angle can cause entrap and compress of the duodenum
	**Factors that narrow this angle include:
	***Significant weight loss, most common factor
	***Corrective spinal surgery for scoliosis lengthens the spine
	***Congenital defects, suggested genetic predisposition
	***Abdominal adhesions

	~~==Clinical Features==~~
	*Early satiety
	*[[Nausea and vomiting]], can be bilious
	*[[Abdominal pain]], mid-abdomen which may be improved with changes of position
	*Abdominal bloating, especially after meals
	*Bleching
	*Weight loss
	*Proximal small bowel obstruction

	~~==Differential Diagnosis==~~
	*See [[Abdominal Pain]]
	*See [[Nausea and vomiting]]

	~~==Evaluation==~~
	*Suspected based on signs and symptoms
	*Diagnosis confirmed by imaging:
	**Upper GI series
	**Upper endoscopy
	**Computed tomography

	~~==Management==~~
	*Primary goal is to correct the underlying cause, typically regain lost weight
	*Acute treatment includes:
	**Adjusting body position to alleviate symptoms such as knee to chest or lying on left side
	**Nasogastric decompression
	**Some patients may require a feeding tube distal to the obstruction or parenteral nutrition
	*Surgery may be required, options include:
	**Strong's procedure: duodenum moved to the right of the SMA
	**Gastrojejunostomy
	**Duodenojejunostomy

	~~==Disposition==~~
	*Depending on the clinical presentation
	*If complete obstruction, may require admission for decompression and nutrition
	*Outcome excellent with early diagnosis and appropriate treatment

	~~==See Also==~~
	~~[[Acute gastric dilation]]~~

	~~==External Links==~~

	~~==References==~~
	~~<references/>~~
	*1. <Karrer FM. Superior Mesenteric Artery Syndrome. Medscape Reference. Jan 2017; http://emedicine.medscape.com/article/932220-overview.>
	*2. <Pleoa A, Constantinescu C, Crumpei F, and Cotea E. Superior mesenteric artery syndrome~~: an unusual cause of intestinal obstruction. "J Gastrointest Liver Dis". Mar 2006; 15(1): 69-72.>~~
	*3. <Lorentziadis M. Wilke's syndrome. A rare cause of duodenal obstruction. "Ann Gastroenterol." 2011; 24(1): 59-61.

	~~[[Category:Vascular~~]]

Zipdoc at 06:19, 15 January 2017

2017-01-15T06:19:22Z

← Older revision		Revision as of 06:19, 15 January 2017
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	*2. <Pleoa A, Constantinescu C, Crumpei F, and Cotea E. Superior mesenteric artery syndrome: an unusual cause of intestinal obstruction. "J Gastrointest Liver Dis". Mar 2006; 15(1): 69-72.>		*2. <Pleoa A, Constantinescu C, Crumpei F, and Cotea E. Superior mesenteric artery syndrome: an unusual cause of intestinal obstruction. "J Gastrointest Liver Dis". Mar 2006; 15(1): 69-72.>
	*3. <Lorentziadis M. Wilke's syndrome. A rare cause of duodenal obstruction. "Ann Gastroenterol." 2011; 24(1): 59-61.		*3. <Lorentziadis M. Wilke's syndrome. A rare cause of duodenal obstruction. "Ann Gastroenterol." 2011; 24(1): 59-61.

			[[Category:Vascular]]

Mackeym2: /* Management */

2017-01-12T22:17:42Z

Management

← Older revision		Revision as of 22:17, 12 January 2017
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	*Primary goal is to correct the underlying cause, typically regain lost weight		*Primary goal is to correct the underlying cause, typically regain lost weight
	*Acute treatment includes:		*Acute treatment includes:
	**Adjusting body position to alleviate symptoms		**Adjusting body position to alleviate symptoms such as knee to chest or lying on left side
	**Nasogastric decompression		**Nasogastric decompression
	**Some patients may require a feeding tube distal to the obstruction or parenteral nutrition		**Some patients may require a feeding tube distal to the obstruction or parenteral nutrition

Mackeym2: /* References */

2017-01-12T22:17:12Z

References

← Older revision		Revision as of 22:17, 12 January 2017
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	*1. <Karrer FM. Superior Mesenteric Artery Syndrome. Medscape Reference. Jan 2017; http://emedicine.medscape.com/article/932220-overview.>		*1. <Karrer FM. Superior Mesenteric Artery Syndrome. Medscape Reference. Jan 2017; http://emedicine.medscape.com/article/932220-overview.>
	*2. <Pleoa A, Constantinescu C, Crumpei F, and Cotea E. Superior mesenteric artery syndrome: an unusual cause of intestinal obstruction. "J Gastrointest Liver Dis". Mar 2006; 15(1): 69-72.>		*2. <Pleoa A, Constantinescu C, Crumpei F, and Cotea E. Superior mesenteric artery syndrome: an unusual cause of intestinal obstruction. "J Gastrointest Liver Dis". Mar 2006; 15(1): 69-72.>
			*3. <Lorentziadis M. Wilke's syndrome. A rare cause of duodenal obstruction. "Ann Gastroenterol." 2011; 24(1): 59-61.
	~~[[Category~~:~~Vascular]]~~

Mackeym2: /* Background */

2017-01-12T22:14:29Z

Background

← Older revision		Revision as of 22:14, 12 January 2017
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	**AKA: Wilke's syndrome		**AKA: Wilke's syndrome
	*Rare condition		*Rare condition
			*1st described by Von Rokitansky in 1861 and then further studied in detail by Wilke in 1912
	*Occurs when the duodenum is compressed between the aorta and the superior mesenteric artery, level of the third portion of the duodenum		*Occurs when the duodenum is compressed between the aorta and the superior mesenteric artery, level of the third portion of the duodenum
	*Can lead to chronic intermittent or acute, partial or complete gastrointestinal obstruction at the level of the duodenum		*Can lead to chronic intermittent or acute, partial or complete gastrointestinal obstruction at the level of the duodenum

Mackeym2: /* Background */

2017-01-12T22:12:24Z

Background

← Older revision		Revision as of 22:12, 12 January 2017
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	==Background==		==Background==
	*Full name: [[Superior Mesenteric Artery Syndrome]]		*Full name: [[Superior Mesenteric Artery Syndrome]]
			**AKA: Wilke's syndrome
	*Rare condition		*Rare condition
	*Occurs when the duodenum is compressed between the aorta and the superior mesenteric artery, level of the third portion of the duodenum		*Occurs when the duodenum is compressed between the aorta and the superior mesenteric artery, level of the third portion of the duodenum

Mackeym2: /* Disposition */

2017-01-12T22:05:12Z

Disposition

← Older revision		Revision as of 22:05, 12 January 2017
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	*Depending on the clinical presentation		*Depending on the clinical presentation
	*If complete obstruction, may require admission for decompression and nutrition		*If complete obstruction, may require admission for decompression and nutrition
			*Outcome excellent with early diagnosis and appropriate treatment

	==See Also==		==See Also==

Mackeym2: /* See Also */

2017-01-12T22:01:49Z

Mackeym2: /* Etiology */

2017-01-12T22:01:22Z

Etiology

← Older revision		Revision as of 22:01, 12 January 2017
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	==Etiology==		==Etiology==
	*SMA takes off from the abdominal aorta surrounded by fatty and lymphatic tissue also known as the mesenteric pad		*SMA takes off from the abdominal aorta surrounded by fatty and lymphatic tissue also known as the mesenteric pad
	*The mesenteric pad helps the SMA form an angle of about ~~38 º and 65º~~ with the abdominal aorta		*The mesenteric pad helps the SMA form an angle of about 45 degrees with the abdominal aorta
	*Third part of the duodenum courses between the angle formed		*Third part of the duodenum courses between the angle formed
	*Narrowing of this angle can cause entrap and compress of the duodenum		*Narrowing of this angle can cause entrap and compress of the duodenum

Mackeym2: /* Evaluation */

2017-01-12T04:45:40Z

Evaluation

← Older revision		Revision as of 04:45, 12 January 2017
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	*Diagnosis confirmed by imaging:		*Diagnosis confirmed by imaging:
	**Upper GI series		**Upper GI series
	**~~Hypotonic duodenography~~		**Upper endoscopy
	**Computed tomography		**Computed tomography

← Older revision		Revision as of 22:01, 12 January 2017
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	==See Also==		==See Also==
			[[Acute gastric dilation]]

	==External Links==		==External Links==