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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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How might superior mesenteric artery syndrome be treated? 

In cases of acute superior mesenteric artery syndrome (SMAS), treatment typically focuses on removing or stopping the underlying cause of the condition.[1] For example, symptoms often improve after lost weight is restored or a body cast is removed.[2] Treatment in most cases is conservative at first and may involve adequate nutrition, nasogastric decompression (a tube passed through the nose into the stomach), and proper positioning after eating (such as lying prone and knee-to-chest position). In some cases, both enteral and parenteral nutritional support may be needed to provide enough calories.[1]

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.[1]

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.[1]
Last updated: 3/26/2014

  1. Frederick Merrill Karrer. Superior Mesenteric Artery Syndrome. Medscape Reference. September 4, 2012; Accessed 3/26/2014.
  2. 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;