Superior mesenteric artery syndrome
Other Names for this Disease
- Arteriomesenteric duodenal compression syndrome
- Cast syndrome
- Vascular compression of the duodenum
- Wilkie syndrome
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Questions on this page
The superior mesenteric artery makes its way between two layers of the mesentery (membranous tissue which carries blood vessels and lymph glands and attaches organs to the abdominal wall) and crosses over the first part of the small intestine, called the duodenum. The duodenum is where partly digested foods from the stomach mix with bile from the gall bladder and digestive juices from the pancreas.
- prolonged bed rest
- rapid, severe weight loss
- rapid growth
- previous abdominal surgery
- use of body casts
- loss of tone in abdominal muscles
SMAS has also been reported to occur in some people with pancreatitis, peptic ulcers, and other inflammatory conditions in the abdomen. Rarely, the condition may be caused by an anatomical abnormality (such as unusual position or location of the artery). Familial SMAS, recurrent SMAS, and idiopathic neonatal SMAS have also been reported.
Affected people can usually then be started on oral liquids, followed by slow and gradual introduction of small and frequent soft meals as tolerated. Then, regular solid foods may be introduced. Metoclopramide treatment may be beneficial for some people.
Surgery may be needed when conservative treatment doesn't work, particularly in people with a long history of progressive weight loss, pronounced duodenal dilatation with stasis, and peptic ulcer disease. However, people should generally try conservative treatment for at least 4-6 weeks before considering surgery.
- Small Intestine. MedlinePlusMedical Encyclopedia. November 8, 2010; http://www.nlm.nih.gov/medlineplus/ency/imagepages/19221.htm. Accessed 7/26/2012.
- Duodenum. MedlinePlus Medical Encyclopedia. October 30, 2010; http://www.nlm.nih.gov/medlineplus/ency/article/002347.htm. Accessed 7/26/2012.
- Frederick Merrill Karrer. Superior Mesenteric Artery Syndrome. Medscape Reference. September 4, 2012; http://emedicine.medscape.com/article/932220-overview. Accessed 3/26/2014.
- Superior Mesenteric Artery (SMA) Syndrome. International Foundation for Functional Gastrointestinal Disorders. January 17, 2013; http://www.iffgd.org/site/gi-disorders/other/sma-syndrome. Accessed 3/26/2014.
- Juan-R. Malagelada, Carolina Malagelada . Chapter 8 - Nausea and Vomiting. In: Mark Feldman, Lawrence S. Friedman, Lawrence J. Brandt. Sleisenger & Fordtran's Gastrointestinal and Liver Disease, 8th edition. Philadelphia, PA : Saunders Elsevier; 2006;
- Lawrence J Brandt. Chapter 35 - Vascular Lesions of the Gastrointestinal Tract. In: Mark Feldman, Lawrence S. Friedman. Sleisenger & Fordtran's Gastrointestinal and Liver Disease, 8th edition. Philadelphia, PA: Saunder Elsevier; 2006;