Advances in Diagnosis and Treatment for Superior Mesenteric Artery Syndrome_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Yong , LUO Yuhong.

Department of General Surgery, The First Affiliated Hospital of Jinan University, Guangzhou 510632, Guangdong Province, China;

Corresponding?author：

Keywords：

Superior mesenteric artery syndrome; Wilkie syndrome; Diagnosis; Treatment

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ObjectiveTo introduce the advances in diagnosis and treatment of superior mesenteric artery syndrome (SMAS). MethodsLiteratures about SMAS published in domestic and abroad were collected and reviewed. ResultsSMAS was a rare medical condition characterized by acute or chronic ileus resulting from vascular compression of the third part of the duodenum by superior mesenteric artery. Images of upper gastrointestinal series, CT, MRI, and color Doppler ultrasonography were the major methods of diagnosing the syndrome and the upper gastrointestinal series was the most important. Conservative approaches were usually preferred to the treatment of SMAS. Surgery was performed on symptomatic patients when conservative treatment failed, and duodenojejunostomy was the best surgical procedure. ConclusionAwareness of the clinical and imaging features may be helpful to diagnosis and treatment of SMAS, and reasonable therapy shall include etiological treatment and relief of the obstruction by conservative treatment or surgery.

Citation： LIU Yong,LUO Yuhong.. Advances in Diagnosis and Treatment for Superior Mesenteric Artery Syndrome. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(2): 225-228. doi: Copy

1.	Rokitansky C. Handbuch der pathologischen Anatomie [M]. Wien, Braunmüller und Seidel, 1842: 187.
2.	Wilkie DPD. Chronic duodenal ileus [J]. Am J Med Sci, 1927, 173: 643649.
3.	雷志盛. 腸系膜上動脈綜合征八例誤診分析 [J]. 臨床誤診誤治, 1998, 11(5): 289.
4.	方立峰, 曾建生. 腸系膜上動脈綜合征15例誤診分析 [J]. 胃腸病學和肝病學雜志, 1993, 2(2): 76.
5.	Wayne ER, Burrington JD. Duodenal obstruction by the superior mesenteric artery in children [J]. Surgery, 1972, 72(5): 762768.
6.	Neri S, Signorelli SS, Mondati E, et al. Ultrasound imaging in diagnosis of superior mesenteric artery syndrome [J]. J Intern Med, 2005, 257(4): 346351.
7.	李建偉, 唐宗聯, 汪虹. 特大面積燒傷并發腸系膜上動脈壓迫綜合癥1例 [J]. 昆明醫學院學報, 2002, 23(4): 99.
8.	Stümpfle R, Wright AR, Walsh J. Superior mesenteric artery syndrome in an HIV positive patient [J]. Sex Transm Infect, 2003, 79(3): 262263.
9.	盧留斌, 崔大勇. HaloVest架致腸系膜上動脈綜合征1例 [J]. 實用醫藥雜志, 2005, 22(9): 846.
10.	Smith BG, HakimZargar M, Thomson JD. Low body mass index: a risk factor for superior mesenteric artery syndrome in adolescents undergoing spinal fusion for scoliosis [J]. J Spinal Disord Tech, 2009, 22(2): 144148.
11.	Goitein D, Gagné DJ, Papasavas PK, et al. Superior mesenteric artery syndrome after laparoscopic RouxenY gastric bypass for morbid obesity [J]. Obes Surg, 2004, 14(7): 10081011.
12.	王元芝, 朱萍, 李風玲. 食管癌術后并發腸系膜上動脈壓迫綜合癥一例 [J]. 實用心腦肺血管病雜志, 2005, 13(4): 240.
13.	AuYong I, Watson NF, Boereboom CL, et al. Endovascular treatment of a Superior Mesenteric Artery Syndrome variant secondary to traumatic pseudoaneurysm [J]. World J Emerg Surg, 2010, 5: 7.
14.	馬向濤, 余力偉, 張芳, 等. 表現為急性胃擴張伴胃壁破裂橫結腸壞死的腸系膜上動脈綜合征 [J]. 中華消化雜志, 2006, 26(7): 472.
15.	Kandil E, Alabbas H, Harbin AC, et al. Superior mesenteric artery syndrome [J]. J La State Med Soc, 2009, 161(5): 285286.
16.	Ko KH, Tsai SH, Yu CY, et al. Unusual complication of superior mesenteric artery syndrome: spontaneous upper gastrointestinal bleeding with hypovolemic shock [J]. J Chin Med Assoc, 2009, 72(1): 4547.
17.	Rod J, Sarnacki S, Petit T, et al. Portal venous gas and thrombosis complicating superior mesenteric artery syndrome (Wilkie’s syndrome) in a child [J]. J Pediatr Surg, 2010, 45(4): 826829.
18.	Tsai CL, Chen MJ, Tan CK, et al. Superior mesenteric artery syndrome with hepatic portal venous gas [J]. Med J Aust, 2007, 186(1): 48.
19.	Konen E, Amitai M, Apter S, et al. CT angiography of superior mesenteric artery syndrome [J]. AJR Am J Roentgenol, 1998, 171(5): 12791281.
20.	方立峰, 王樹俊, 胡威, 等. 胃鏡檢查腸系膜上動脈綜合征 [J]. 醫藥論壇雜志, 2008, 29(8): 5455.
21.	覃峰, 申國光, 龍行安, 等. 腸系膜上動脈綜合征誤診漏診原因分析 [J]. 中國醫學影像學雜志, 2003, 11(2): 154.
22.	Mauceri B, Misseri M, Tsami A et al. Ultrasound in diagnosis of superior mesenteric artery syndrome [J]. Clin Ter, 2010, 161(1): 3537.
23.	Sundaram P, Gupte GL, Millar AJ, et al. Endoscopic ultrasound is a useful diagnostic test for superior mesenteric artery syndrome in children [J]. J Pediatr Gastroenterol Nutr, 2007, 45(4): 474476.
24.	Di Matteo F, Picconi F, Sansoni I, et al. Superior mesenteric artery syndrome diagnosed with linear endoscopic ultrasound [J]. Endoscopy, 2010, 42 Suppl 2: E67E68.
25.	唐光佐, 董文廣, 黃奕華. 腸系膜上動脈綜合征的診斷和治療（附45例報告） [J]. 中國實用外科雜志, 1995, 15(6): 374375.
26.	蔣紅梅, 盧艷如, 陳玉龍. 抗抑郁藥對腸系膜上動脈綜合征伴抑郁研究 [J]. 醫藥論壇雜志, 2007, 28(7): 35.
27.	黃建偉, 潘潔, 溫凌, 等. 早期腸內營養在腸系膜上動脈綜合征中的應用 [J]. 廣州醫學院學報, 2008, 36(4): 2729.
28.	丁凱, 汪志明, 江志偉. 經PEJ腸內營養在腸系膜上動脈壓迫綜合征治療中的作用 [J]. 腸外與腸內營養, 2009, 16(2): 8486.
29.	Biank V, Werlin S. Superior mesenteric artery syndrome in children: a 20year experience [J]. J Pediatr Gastroenterol Nutr, 2006, 42(5): 522525.
30.	Strong EK. Mechanics of arteriomesentric duodenal obstruction and direct surgical attack upon etiology [J]. Ann Surg, 1958, 148(5): 725730.
31.	孫可望, 鄒壽椿, 施敦, 等. 腸系膜上動脈綜合征21例術式的選擇 [J]. 中華普通外科雜志, 2005, 20(1): 1820.
32.	鄒小明. 手術治療腸系膜上動脈綜合征的術式探討 [J]. 中國實用外科雜志, 2006, 26(6): 471472.
33.	陳歷恒, 蔣曉忠, 杜一平, 等. 腸系膜上動脈壓迫綜合征的診斷及術式選擇評價 [J]. 中國普外基礎與臨床雜志, 2008, 15(7): 518521.
34.	Massoud WZ. Laparoscopic management of superior mesenteric artery syndrome [J]. Int Surg, 1995, 80(4): 322327.
35.	Gersin KS, Heniford BT. Laparoscopic duodenojejunostomy for treatment of superior mesenteric artery syndrome [J]. JSLS, 1998, 2(3): 281284.
36.	Munene G, Knab M, Parag B. Laparoscopic duodenojejunostomy for superior mesenteric artery syndrome [J]. Am Surg, 2010, 76(3): 321324.

1. Rokitansky C. Handbuch der pathologischen Anatomie [M]. Wien, Braunmüller und Seidel, 1842: 187.
2. Wilkie DPD. Chronic duodenal ileus [J]. Am J Med Sci, 1927, 173: 643649.
3. 雷志盛. 腸系膜上動脈綜合征八例誤診分析 [J]. 臨床誤診誤治, 1998, 11(5): 289.
4. 方立峰, 曾建生. 腸系膜上動脈綜合征15例誤診分析 [J]. 胃腸病學和肝病學雜志, 1993, 2(2): 76.
5. Wayne ER, Burrington JD. Duodenal obstruction by the superior mesenteric artery in children [J]. Surgery, 1972, 72(5): 762768.
6. Neri S, Signorelli SS, Mondati E, et al. Ultrasound imaging in diagnosis of superior mesenteric artery syndrome [J]. J Intern Med, 2005, 257(4): 346351.
7. 李建偉, 唐宗聯, 汪虹. 特大面積燒傷并發腸系膜上動脈壓迫綜合癥1例 [J]. 昆明醫學院學報, 2002, 23(4): 99.
8. Stümpfle R, Wright AR, Walsh J. Superior mesenteric artery syndrome in an HIV positive patient [J]. Sex Transm Infect, 2003, 79(3): 262263.
9. 盧留斌, 崔大勇. HaloVest架致腸系膜上動脈綜合征1例 [J]. 實用醫藥雜志, 2005, 22(9): 846.
10. Smith BG, HakimZargar M, Thomson JD. Low body mass index: a risk factor for superior mesenteric artery syndrome in adolescents undergoing spinal fusion for scoliosis [J]. J Spinal Disord Tech, 2009, 22(2): 144148.
11. Goitein D, Gagné DJ, Papasavas PK, et al. Superior mesenteric artery syndrome after laparoscopic RouxenY gastric bypass for morbid obesity [J]. Obes Surg, 2004, 14(7): 10081011.
12. 王元芝, 朱萍, 李風玲. 食管癌術后并發腸系膜上動脈壓迫綜合癥一例 [J]. 實用心腦肺血管病雜志, 2005, 13(4): 240.
13. AuYong I, Watson NF, Boereboom CL, et al. Endovascular treatment of a Superior Mesenteric Artery Syndrome variant secondary to traumatic pseudoaneurysm [J]. World J Emerg Surg, 2010, 5: 7.
14. 馬向濤, 余力偉, 張芳, 等. 表現為急性胃擴張伴胃壁破裂橫結腸壞死的腸系膜上動脈綜合征 [J]. 中華消化雜志, 2006, 26(7): 472.
15. Kandil E, Alabbas H, Harbin AC, et al. Superior mesenteric artery syndrome [J]. J La State Med Soc, 2009, 161(5): 285286.
16. Ko KH, Tsai SH, Yu CY, et al. Unusual complication of superior mesenteric artery syndrome: spontaneous upper gastrointestinal bleeding with hypovolemic shock [J]. J Chin Med Assoc, 2009, 72(1): 4547.
17. Rod J, Sarnacki S, Petit T, et al. Portal venous gas and thrombosis complicating superior mesenteric artery syndrome (Wilkie’s syndrome) in a child [J]. J Pediatr Surg, 2010, 45(4): 826829.
18. Tsai CL, Chen MJ, Tan CK, et al. Superior mesenteric artery syndrome with hepatic portal venous gas [J]. Med J Aust, 2007, 186(1): 48.
19. Konen E, Amitai M, Apter S, et al. CT angiography of superior mesenteric artery syndrome [J]. AJR Am J Roentgenol, 1998, 171(5): 12791281.
20. 方立峰, 王樹俊, 胡威, 等. 胃鏡檢查腸系膜上動脈綜合征 [J]. 醫藥論壇雜志, 2008, 29(8): 5455.
21. 覃峰, 申國光, 龍行安, 等. 腸系膜上動脈綜合征誤診漏診原因分析 [J]. 中國醫學影像學雜志, 2003, 11(2): 154.
22. Mauceri B, Misseri M, Tsami A et al. Ultrasound in diagnosis of superior mesenteric artery syndrome [J]. Clin Ter, 2010, 161(1): 3537.
23. Sundaram P, Gupte GL, Millar AJ, et al. Endoscopic ultrasound is a useful diagnostic test for superior mesenteric artery syndrome in children [J]. J Pediatr Gastroenterol Nutr, 2007, 45(4): 474476.
24. Di Matteo F, Picconi F, Sansoni I, et al. Superior mesenteric artery syndrome diagnosed with linear endoscopic ultrasound [J]. Endoscopy, 2010, 42 Suppl 2: E67E68.
25. 唐光佐, 董文廣, 黃奕華. 腸系膜上動脈綜合征的診斷和治療（附45例報告） [J]. 中國實用外科雜志, 1995, 15(6): 374375.
26. 蔣紅梅, 盧艷如, 陳玉龍. 抗抑郁藥對腸系膜上動脈綜合征伴抑郁研究 [J]. 醫藥論壇雜志, 2007, 28(7): 35.
27. 黃建偉, 潘潔, 溫凌, 等. 早期腸內營養在腸系膜上動脈綜合征中的應用 [J]. 廣州醫學院學報, 2008, 36(4): 2729.
28. 丁凱, 汪志明, 江志偉. 經PEJ腸內營養在腸系膜上動脈壓迫綜合征治療中的作用 [J]. 腸外與腸內營養, 2009, 16(2): 8486.
29. Biank V, Werlin S. Superior mesenteric artery syndrome in children: a 20year experience [J]. J Pediatr Gastroenterol Nutr, 2006, 42(5): 522525.
30. Strong EK. Mechanics of arteriomesentric duodenal obstruction and direct surgical attack upon etiology [J]. Ann Surg, 1958, 148(5): 725730.
31. 孫可望, 鄒壽椿, 施敦, 等. 腸系膜上動脈綜合征21例術式的選擇 [J]. 中華普通外科雜志, 2005, 20(1): 1820.
32. 鄒小明. 手術治療腸系膜上動脈綜合征的術式探討 [J]. 中國實用外科雜志, 2006, 26(6): 471472.
33. 陳歷恒, 蔣曉忠, 杜一平, 等. 腸系膜上動脈壓迫綜合征的診斷及術式選擇評價 [J]. 中國普外基礎與臨床雜志, 2008, 15(7): 518521.
34. Massoud WZ. Laparoscopic management of superior mesenteric artery syndrome [J]. Int Surg, 1995, 80(4): 322327.
35. Gersin KS, Heniford BT. Laparoscopic duodenojejunostomy for treatment of superior mesenteric artery syndrome [J]. JSLS, 1998, 2(3): 281284.
36. Munene G, Knab M, Parag B. Laparoscopic duodenojejunostomy for superior mesenteric artery syndrome [J]. Am Surg, 2010, 76(3): 321324.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Advances in Diagnosis and Treatment for Superior Mesenteric Artery Syndrome

Abstract Full text Figures/Tables Video References Cited by

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