Superior Mesenteric Artery Syndrome
Duodenal Obstruction
Jejunostomy
Mesenteric Artery, Superior
Anterior Spinal Artery Syndrome
Mesenteric Arteries
Duodenum
Laparoscopy
Tomography, X-Ray Computed
Mesenteric Vascular Occlusion
Celiac Artery
Infarction
Mesenteric Artery, Inferior
Spinal Cord Vascular Diseases
Superior mesenteric artery syndrome in identical twin brothers. (1/36)
We report two identical male twins who suffered from superior mesenteric artery (SMA) syndrome. A 28-year-old man was admitted for investigation of postprandial nausea and vomiting. Upper gastrointestinal examination revealed a dilated proximal duodenum with an abrupt vertical cutoff of barium flow in the third portion of the duodenum, establishing the diagnosis of SMA syndrome. One year later, his twin brother also presented similar symptoms and was radiologically diagnosed as SMA syndrome. The twin brothers did not respond adequately to conservative therapy and underwent duodenojejunostomy. This is the first report of SMA syndrome in identical twins. (+info)Diabetes mellitus associated with superior mesenteric artery syndrome: report of two cases. (2/36)
We observed two patients with diabetes who were suffering from nausea, vomiting and epigastralgia after meals. These symptoms subsided when lying on their left side. Since the 2 patients had autonomic neuropathy, at first, the symptoms seemed to be attributable to diabetic gastroparesis. However, they were diagnosed as having superior mesenteric artery syndrome by hypotonic duodenography. These finding suggest that in diabetic patients who have a history of excessive weight loss superior mesenteric artery syndrome should be ruled out even though they have autonomic neuropathy. (+info)Superior mesenteric artery syndrome due to an aortic aneurysm in a renal transplant recipient. (3/36)
Superior mesenteric artery (SMA) syndrome is a rare disease in which the third portion of the duodenum is compressed by SMA. There are many causes leading to the SMA syndrome, however it's extremely rare that aortic aneurysm causes a SMA syndrome. We report a case of a successfully treated SMA syndrome due to an abdominal aortic aneurysm in a renal transplant recipient. The patient was a 52-yr-old woman with a thin stature (weight 40 kg, height 164 cm). She received a renal transplant 8 yr before, and had hypertension and abdominal aortic aneurysm. Her SMA syndrome developed in a prolonged supine position for the accidental rib fractures and was diagnosed by clinical and radiological findings. After a surgical correction (resection of an aneurysm and aortobiiliac bypass with an inverted Y graft), her symptoms relieved without deterioration of the graft function. (+info)Laparoscopic duodenojejunostomy for management of superior mesenteric artery syndrome: two cases report and a review of the literature. (4/36)
Superior mesenteric artery(SMA) syndrome is rare disorder, which is caused by a reduction in the aortomesenteric angle causing a duodenal obstruction. It is usually occurs after a period of weight loss, nausea, and vomiting by a partial obstruction of the third portion of the duodenum. If conservative management fails then a laparotomy with a duodenojejunostomy is indicated. Recently, a minimally invasive or laparoscopic approach to the retroperitoneum or duodenal detachment was introduced. Although the role of a laparoscopy in managing SMA syndrome is not clearly defined, a laparoscopic duodenojejunostomy may be an alternative approach to the surgical treatment of SMA syndrome cases. Two cases of superior mesenteric artery syndrome that were treated laparoscopically after medical therapy failure are described. The 4-port procedure was performed. A dilated bowel on the third portion of the duodenum was observed below the transverse mesocolon and to right of the superior mesenteric artery. A proximal loop of the jejunum was anastomosed to the duodenum using an endoscopic GIA stapler. The surgery time and hospital length of stay were acceptable. No complications were encountered in this study. A laparoscopic duodenojejunostomy is a feasible alternative option for treating SMA syndrome. It provides the benefits of being a definitive and minimally invasive surgical technique in a duodenal obstruction. (+info)Laparoscopic management of superior mesenteric artery syndrome. (5/36)
OBJECTIVES: The differential diagnosis of intestinal obstruction includes mechanical obstruction, obstruction secondary to systemic disease, and idiopathic intestinal pseudo-obstruction. The causes of these are extensive; however, the majority of cases involve a mechanical cause. Superior mesenteric artery syndrome (SMAS) is a rare and controversial form of mechanical obstruction with just over 300 well-defined cases described in the literature. The diagnosis is often difficult to establish, even after surgery. In addition, this syndrome sometimes may be managed conservatively, leaving a definitive diagnosis unproven. We describe herein 2 patients with SMAS successfully treated with laparoscopic duodenojejunostomy. METHODS: Two cases of SMAS occurred in young men ages 23 and 34. The workup included a consultation with a gastroenterologist, an upper gastrointestinal (GI) endoscopy, upper GI series with small bowel follow-through, computed tomography scan, ultrasound of the abdomen, and abdominal aortogram. This diagnosis was established after consultation with the surgeon and the gastroenterologist in each case. RESULTS: Laparoscopic duodenojejunostomy was performed in each case, and both patients have had complete resolution of their preoperative symptoms. CONCLUSIONS: A laparoscopic approach to the management of superior mesenteric artery syndrome is a reasonable and successful way of treating these patients. (+info)Laparoscopic treatment of superior mesenteric artery syndrome. (6/36)
BACKGROUND: Superior mesenteric artery syndrome is caused by compression of the third portion of the duodenum by the superior mesenteric artery. Many disease states predispose one to this condition. METHODS: We present a case report of a young female patient who presented with gastro-duodenal obstruction from superior mesenteric artery syndrome and subsequently underwent surgical treatment with minimally invasive techniques. Pathophysiology of SMA syndrome is reviewed. RESULTS: The cause of superior mesenteric artery syndrome is variable but always results in duodenal obstruction. Surgery is one treatment option that is effective and can be performed laparoscopically. CONCLUSION: Laparoscopic duodenojejunostomy is an acceptable method of treating superior mesenteric artery syndrome. (+info)Superior mesenteric artery syndrome following scoliosis surgery: its risk indicators and treatment strategy. (7/36)
AIM: To investigate the risk indicators, pattern of clinical presentation and treatment strategy of superior mesenteric artery syndrome (SMAS) after scoliosis surgery. METHODS: From July 1997 to October 2003, 640 patients with adolescent scoliosis who had undergone surgical treatment were evaluated prospectively, and among them seven patients suffered from SMAS after operation. Each patient was assigned a percentile for weight and a percentile for height. Values of the 5th, 10th, 25th, 50th, 75th, and 95th percentiles were selected to divide the observations. The sagittal Cobb angle was used to quantify thoracic or thoracolumbar kyphosis. All the seven patients presented with nausea and intermittent vomiting about 5 d after operation. An upper gastrointestinal barium contrast study showed a straight-line cutoff at the third portion of the duodenum representing extrinsic compression by the superior mesenteric artery (SMA). RESULTS: The value of height in the seven patients with SMAS was above the mean of sex- and age-matched normal population, and the height percentile ranged from 5% to 50%. On the contrary, the value of weight was below the mean of normal population with the weight percentile ranging from 5% to 25%. Among the seven patients, four had a thoracic hyperkyphosis ranging from 55 degrees to 88 degrees (average 72 degrees), two had a thoracolumbar kyphosis of 25 degrees and 32 degrees respectively. The seven patients were treated with fasting, antiemetic medication, and intravenous fluids infusion. Reduction or suspense of traction was adopted in three patients with SMAS during halo-femoral traction after anterior release of scoliosis. All the patients recovered completely with no sequelae. No one required operative intervention with a laparotomy. CONCLUSION: Height percentile < 50%, weight percentile < 25%, sagittal kyphosis, heavy and quick halo-femoral traction after spinal anterior release are the potential risk indicators for SMAS in patients undergoing correction surgery for adolescent scoliosis. (+info)Syndrome of duodenal compression by the superior mesenteric artery following restorative proctocolectomy: a case report and review of literature. (8/36)
CONTEXT: Restorative proctocolectomy with anastomosis of an ileal pouch to the anal canal is a new and rare cause for triggering the syndrome of duodenal compression by the superior mesenteric artery. Restorative proctocolectomy requires assessment of the position of the duodenum in relation to aortomesenteric constriction to avoid the occurrence of duodenal compression by the superior mesenteric artery. CASE REPORT: The authors report on a case of this syndrome in a patient with familial adenomatous polyposis and review the literature on the etiopathogenesis, diagnosis, treatment and prevention of this unusual entity. (+info)Superior Mesenteric Artery (SMA) Syndrome, also known as Wilkie's syndrome, is a rare vascular compression disorder. It occurs when the superior mesenteric artery and the abdominal aorta compress the third part of the duodenum, resulting in partial or complete duodenal obstruction. This compression is often caused by a loss of the normal fat pad that separates these vessels and the duodenum, which can be due to significant weight loss, surgery, or other conditions. Symptoms may include abdominal pain, nausea, vomiting, early satiety, and weight loss. The diagnosis is typically made with imaging studies such as an upper GI series or CT scan. Treatment options range from dietary modifications and medical management to surgical intervention.
Duodenostomy is a surgical procedure that creates an opening (stoma) into the duodenum, which is the first part of the small intestine. This procedure is typically performed to divert the flow of digestive secretions and contents away from a diseased or obstructed area of the gastrointestinal tract.
A duodenostomy may be created as a temporary measure to allow a portion of the intestine to heal or as a permanent solution for conditions such as chronic inflammatory bowel disease, cancer, or congenital abnormalities. The stoma can be located on the abdominal wall, allowing for the external drainage of digestive secretions and contents into a collection bag.
It is important to note that the specific medical definition and indications for duodenostomy may vary based on individual clinical context and patient needs. Therefore, it is always best to consult with a healthcare professional or medical expert for accurate information.
Duodenal obstruction is a medical condition characterized by the blockage or impediment of the normal flow of contents through the duodenum, which is the first part of the small intestine. This blockage can be partial or complete and can be caused by various factors such as:
1. Congenital abnormalities: Duodenal atresia or stenosis, where there is a congenital absence or narrowing of a portion of the duodenum.
2. Inflammatory conditions: Duodenitis, Crohn's disease, or tumors that cause swelling and inflammation in the duodenum.
3. Mechanical obstructions: Gallstones, tumors, strictures, or adhesions (scar tissue) from previous surgeries can physically block the duodenum.
4. Neuromuscular disorders: Conditions like progressive systemic sclerosis or amyloidosis that affect the neuromuscular function of the intestines can lead to duodenal obstruction.
Symptoms of duodenal obstruction may include nausea, vomiting (often with bilious or fecal matter), abdominal pain, distention, and decreased bowel movements. Diagnosis typically involves imaging studies such as X-rays, CT scans, or upper gastrointestinal series to visualize the blockage. Treatment depends on the underlying cause but may involve surgery, endoscopic procedures, or medications to manage symptoms and address the obstruction.
A jejunostomy is a surgical procedure where an opening (stoma) is created in the lower part of the small intestine, called the jejunum. This stoma allows for the passage of nutrients and digestive enzymes from the small intestine into a tube or external pouch, bypassing the mouth, esophagus, stomach, and upper small intestine (duodenum).
Jejunostomy is typically performed to provide enteral nutrition support in patients who are unable to consume food or liquids by mouth due to various medical conditions such as dysphagia, gastroparesis, bowel obstruction, or after certain surgical procedures. The jejunostomy tube can be used for short-term or long-term nutritional support, depending on the patient's needs and underlying medical condition.
An enterostomy is a surgical procedure that creates an opening from the intestine to the abdominal wall, which allows for the elimination of waste from the body. This opening is called a stoma and can be temporary or permanent, depending on the individual's medical condition. There are several types of enterostomies, including colostomy, ileostomy, and jejunostomy, which differ based on the specific location in the intestine where the stoma is created.
The purpose of an enterostomy may vary, but it is often performed to divert the flow of waste away from a diseased or damaged section of the intestine, allowing it to heal. Common reasons for an enterostomy include inflammatory bowel disease, cancer, trauma, and birth defects.
After the surgery, patients will need to wear a pouching system over the stoma to collect waste. They will also require specialized care and education on how to manage their stoma and maintain their overall health. With proper care and support, individuals with an enterostomy can lead active and fulfilling lives.
The superior mesenteric artery (SMA) is a major artery that supplies oxygenated blood to the intestines, specifically the lower part of the duodenum, jejunum, ileum, cecum, ascending colon, and the first and second parts of the transverse colon. It originates from the abdominal aorta, located just inferior to the pancreas, and passes behind the neck of the pancreas before dividing into several branches to supply the intestines. The SMA is an essential vessel in the digestive system, providing blood flow for nutrient absorption and overall gut function.
Anterior Spinal Artery Syndrome (ASAS) is a medical condition that affects the blood supply to the anterior portion of the spinal cord. This results in a lack of oxygen and nutrients being delivered to the affected area, causing damage to the nerves and tissues.
The anterior spinal artery is responsible for supplying blood to the front two-thirds of the spinal cord, which includes the corticospinal tracts (responsible for motor function) and the spinothalamic tracts (responsible for pain, temperature, and touch sensation).
ASAS can be caused by various conditions that affect the blood flow in the anterior spinal artery, such as atherosclerosis, embolism, vasculitis, or trauma. The symptoms of ASAS depend on the severity and location of the injury but may include:
* Paralysis or weakness in the legs (paraplegia) or all four limbs (tetraplegia)
* Loss of pain and temperature sensation below the level of the injury
* Absent or reduced reflexes
* Autonomic dysfunction, such as bladder and bowel incontinence or sexual dysfunction
* Muscle spasticity or rigidity
The diagnosis of ASAS is typically made based on clinical examination, imaging studies (such as MRI or CT angiography), and sometimes cerebrospinal fluid analysis. Treatment for ASAS focuses on addressing the underlying cause, managing symptoms, and promoting rehabilitation and recovery.
The mesenteric arteries are the arteries that supply oxygenated blood to the intestines. There are three main mesenteric arteries: the superior mesenteric artery, which supplies blood to the small intestine (duodenum to two-thirds of the transverse colon) and large intestine (cecum, ascending colon, and the first part of the transverse colon); the inferior mesenteric artery, which supplies blood to the distal third of the transverse colon, descending colon, sigmoid colon, and rectum; and the middle colic artery, which is a branch of the superior mesenteric artery that supplies blood to the transverse colon. These arteries are important in maintaining adequate blood flow to the intestines to support digestion and absorption of nutrients.
The duodenum is the first part of the small intestine, immediately following the stomach. It is a C-shaped structure that is about 10-12 inches long and is responsible for continuing the digestion process that begins in the stomach. The duodenum receives partially digested food from the stomach through the pyloric valve and mixes it with digestive enzymes and bile produced by the pancreas and liver, respectively. These enzymes help break down proteins, fats, and carbohydrates into smaller molecules, allowing for efficient absorption in the remaining sections of the small intestine.
Laparoscopy is a surgical procedure that involves the insertion of a laparoscope, which is a thin tube with a light and camera attached to it, through small incisions in the abdomen. This allows the surgeon to view the internal organs without making large incisions. It's commonly used to diagnose and treat various conditions such as endometriosis, ovarian cysts, infertility, and appendicitis. The advantages of laparoscopy over traditional open surgery include smaller incisions, less pain, shorter hospital stays, and quicker recovery times.
X-ray computed tomography (CT or CAT scan) is a medical imaging method that uses computer-processed combinations of many X-ray images taken from different angles to produce cross-sectional (tomographic) images (virtual "slices") of the body. These cross-sectional images can then be used to display detailed internal views of organs, bones, and soft tissues in the body.
The term "computed tomography" is used instead of "CT scan" or "CAT scan" because the machines take a series of X-ray measurements from different angles around the body and then use a computer to process these data to create detailed images of internal structures within the body.
CT scanning is a noninvasive, painless medical test that helps physicians diagnose and treat medical conditions. CT imaging provides detailed information about many types of tissue including lung, bone, soft tissue and blood vessels. CT examinations can be performed on every part of the body for a variety of reasons including diagnosis, surgical planning, and monitoring of therapeutic responses.
In computed tomography (CT), an X-ray source and detector rotate around the patient, measuring the X-ray attenuation at many different angles. A computer uses this data to construct a cross-sectional image by the process of reconstruction. This technique is called "tomography". The term "computed" refers to the use of a computer to reconstruct the images.
CT has become an important tool in medical imaging and diagnosis, allowing radiologists and other physicians to view detailed internal images of the body. It can help identify many different medical conditions including cancer, heart disease, lung nodules, liver tumors, and internal injuries from trauma. CT is also commonly used for guiding biopsies and other minimally invasive procedures.
In summary, X-ray computed tomography (CT or CAT scan) is a medical imaging technique that uses computer-processed combinations of many X-ray images taken from different angles to produce cross-sectional images of the body. It provides detailed internal views of organs, bones, and soft tissues in the body, allowing physicians to diagnose and treat medical conditions.
Mesenteric vascular occlusion refers to the blockage or obstruction of the blood vessels that supply the intestines, specifically the mesenteric arteries and veins. This condition can result in insufficient blood flow to the intestines, leading to ischemia (inadequate oxygen supply) and potential necrosis (tissue death).
There are two primary types of mesenteric vascular occlusion:
1. Mesenteric arterial occlusion: This occurs when the mesenteric artery, which carries oxygenated blood from the heart to the intestines, becomes blocked. The most common causes include atherosclerosis (plaque buildup in the arteries), embolism (a clot or particle that travels from another part of the body and lodges in the artery), and thrombosis (a blood clot forming directly in the artery).
2. Mesenteric venous occlusion: This happens when the mesenteric vein, which returns deoxygenated blood from the intestines to the heart, becomes obstructed. The most common causes include thrombophlebitis (inflammation and clot formation in the vein), tumors, or abdominal trauma.
Symptoms of mesenteric vascular occlusion may include severe abdominal pain, nausea, vomiting, diarrhea, and bloody stools. Rapid diagnosis and treatment are crucial to prevent intestinal tissue damage and potential life-threatening complications such as sepsis or shock. Treatment options typically involve surgical intervention, anticoagulation therapy, or endovascular procedures to restore blood flow.
The celiac artery, also known as the anterior abdominal aortic trunk, is a major artery that originates from the abdominal aorta and supplies oxygenated blood to the foregut, which includes the stomach, liver, spleen, pancreas, and upper part of the duodenum. It branches into three main branches: the left gastric artery, the splenic artery, and the common hepatic artery. The celiac artery plays a crucial role in providing blood to these vital organs, and any disruption or damage to it can lead to serious health consequences.
Infarction is the term used in medicine to describe the death of tissue (also known as an "area of necrosis") due to the lack of blood supply. This can occur when a blood vessel that supplies oxygen and nutrients to a particular area of the body becomes blocked or obstructed, leading to the deprivation of oxygen and nutrients necessary for the survival of cells in that region.
The blockage in the blood vessel is usually caused by a clot (thrombus) or an embolus, which is a small particle that travels through the bloodstream and lodges in a smaller vessel. The severity and extent of infarction depend on several factors, including the size and location of the affected blood vessel, the duration of the obstruction, and the presence of collateral circulation (alternative blood vessels that can compensate for the blocked one).
Common examples of infarctions include myocardial infarction (heart attack), cerebral infarction (stroke), and pulmonary infarction (lung tissue death due to obstruction in the lung's blood vessels). Infarctions can lead to various symptoms, depending on the affected organ or tissue, and may require medical intervention to manage complications and prevent further damage.
The Inferior Mesenteric Artery (IMA) is a major artery that supplies blood to the distal portion of the large intestine, including the descending colon, sigmoid colon, and rectum. It originates from the abdominal aorta, typically at the level of the third lumbar vertebra (L3), and descends anteriorly to the left psoas major muscle before crossing the iliac crest and entering the pelvis.
Once in the pelvis, the IMA divides into several branches, including the left colic artery, which supplies the descending colon; the sigmoidal branches, which supply the sigmoid colon; and the superior rectal artery, which supplies the upper part of the rectum. The inferior mesenteric artery plays a crucial role in maintaining blood flow to the distal gut and is often evaluated during surgical procedures involving the abdomen or pelvis.
A syndrome, in medical terms, is a set of symptoms that collectively indicate or characterize a disease, disorder, or underlying pathological process. It's essentially a collection of signs and/or symptoms that frequently occur together and can suggest a particular cause or condition, even though the exact physiological mechanisms might not be fully understood.
For example, Down syndrome is characterized by specific physical features, cognitive delays, and other developmental issues resulting from an extra copy of chromosome 21. Similarly, metabolic syndromes like diabetes mellitus type 2 involve a group of risk factors such as obesity, high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that collectively increase the risk of heart disease, stroke, and diabetes.
It's important to note that a syndrome is not a specific diagnosis; rather, it's a pattern of symptoms that can help guide further diagnostic evaluation and management.
Spinal cord vascular diseases refer to a group of disorders that affect the blood vessels of the spinal cord. These conditions can result in insufficient blood supply to the spinal cord tissue, leading to ischemia (lack of oxygen) and infarction (tissue death). There are several types of spinal cord vascular diseases, including:
1. Spinal Cord Infarction: This is a rare condition that occurs due to the blockage or narrowing of the arteries supplying blood to the spinal cord. It can result in sudden onset of weakness, numbness, or paralysis in parts of the body served by the affected spinal cord region.
2. Spinal Cord Aneurysm: This is a localized dilation or bulging of a weakened area in the wall of a blood vessel that supplies the spinal cord. If an aneurysm ruptures, it can cause bleeding into the spinal cord tissue, leading to neurological deficits.
3. Spinal Cord Arteriovenous Malformations (AVMs): These are abnormal connections between the arteries and veins in the spinal cord. AVMs can lead to bleeding, ischemia, or both, resulting in various neurological symptoms.
4. Spinal Cord Dural Arteriovenous Fistulas (dAVFs): These are abnormal communications between the spinal artery and a vein located outside the dura mater (the protective covering of the spinal cord). dAVFs can cause venous congestion, leading to ischemia and neurological dysfunction.
5. Spinal Cord Vasculitis: This is an inflammation of the blood vessels in the spinal cord, which can lead to narrowing or blockage of the affected vessels. It can result in various neurological symptoms, such as weakness, numbness, or pain.
Treatment for spinal cord vascular diseases depends on the specific condition and its severity. Treatment options may include medications, surgery, endovascular procedures, or a combination of these approaches.
Splanchnic circulation refers to the blood flow to the visceral organs, including the gastrointestinal tract, pancreas, spleen, and liver. These organs receive a significant portion of the cardiac output, with approximately 25-30% of the total restingly going to the splanchnic circulation. The splanchnic circulation is regulated by a complex interplay of neural and hormonal mechanisms that help maintain adequate blood flow to these vital organs while also allowing for the distribution of blood to other parts of the body as needed.
The splanchnic circulation is unique in its ability to vasodilate and increase blood flow significantly in response to meals or other stimuli, such as stress or hormonal changes. This increased blood flow helps support the digestive process and absorption of nutrients. At the same time, the body must carefully regulate this blood flow to prevent a significant drop in blood pressure or overloading the heart with too much work.
Overall, the splanchnic circulation plays a critical role in maintaining the health and function of the body's vital organs, and dysregulation of this system can contribute to various diseases, including digestive disorders, liver disease, and cardiovascular disease.