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Superior mesenteric artery compression syndrome

C S Lee, J C Mangla

    The American Journal of Gastroenterology
    |August 1, 1978
    PubMed
    Summary
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    Superior mesenteric artery compression syndrome is more prevalent in chronic-care facilities. Duodenojejunostomy is the preferred surgical treatment for severe cases, offering better outcomes than gastrojejunostomy.

    Area of Science:

    • Gastroenterology
    • Surgical Oncology
    • Abdominal Surgery

    Background:

    • Superior mesenteric artery compression syndrome (SMAS) is a rare condition.
    • Diagnosis often occurs in patients with chronic wasting diseases and significant weight loss.
    • Previous studies suggest varying surgical interventions for SMAS.

    Observation:

    • A retrospective review identified 17 SMAS cases over 10 years.
    • Prevalence was significantly higher in chronic-care hospitals compared to acute general hospitals.
    • Patients presenting with chronic wasting diseases, immobility, and weight loss are at higher risk.

    Findings:

    • Duodenojejunostomy demonstrated superior efficacy in treating severe SMAS compared to gastrojejunostomy or lysis of the ligament of Treitz.

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  • Gastrojejunostomy provided gastric decompression but failed to adequately relieve duodenal obstruction.
  • Lysis of the ligament of Treitz was insufficient in some cases, requiring subsequent duodenojejunostomy.

    • Implications:

    • SMAS should be considered in chronically ill, bedridden patients experiencing unexplained vomiting or aspiration.
    • Duodenojejunostomy is recommended as the optimal surgical approach for severe SMAS.
    • Further research into the long-term efficacy of different surgical interventions is warranted.