Superior mesenteric artery syndrome

Superior mesenteric artery compressing the duodenum, featuring the superior mesenteric artery syndrome

Superior mesenteric artery (SMA) syndrome is a gastro-vascular disorder in which the third and final portion of the duodenum is compressed between the abdominal aorta (AA) and the overlying superior mesenteric artery. This rare, potentially life-threatening syndrome is typically caused by an angle of 6–25° between the AA and the SMA, in comparison to the normal range of 38–56°, due to a lack of retroperitoneal and visceral fat (mesenteric fat). In addition, the aortomesenteric distance is 2–8 millimeters, as opposed to the typical 10–20.[1] However, a narrow SMA angle alone is not enough to make a diagnosis, because patients with a low BMI, most notably children, have been known to have a narrow SMA angle with no symptoms of SMA syndrome.[2]

SMA syndrome is also known as Wilkie's syndrome, cast syndrome, mesenteric root syndrome, chronic duodenal ileus and intermittent arterio-mesenteric occlusion.[3] It is distinct from nutcracker syndrome, which is the entrapment of the left renal vein between the AA and the SMA, although it is possible to be diagnosed with both conditions.[4]

  1. ^ Cite error: The named reference Shetty was invoked but never defined (see the help page).
  2. ^ Arthurs OJ, Mehta U, Set PA (August 2012). "Nutcracker and SMA syndromes: What is the normal SMA angle in children?". European Journal of Radiology. 81 (8): e854–e861. doi:10.1016/j.ejrad.2012.04.010. PMID 22579528.
  3. ^ Laffont I, Bensmail D, Rech C, Prigent G, Loubert G, Dizien O (February 2002). "Late superior mesenteric artery syndrome in paraplegia: case report and review". Spinal Cord. 40 (2): 88–91. doi:10.1038/sj.sc.3101255. PMID 11926421.
  4. ^ Barsoum MK, Shepherd RF, Welch TJ (August 2008). "Patient with both Wilkie syndrome and nutcracker syndrome". Vascular Medicine. 13 (3): 247–250. doi:10.1177/1358863X08092272. PMID 18687762. S2CID 307360.