title: Superior mesenteric artery syndrome: an approach to the diagnosis and management of upper gastrointestinal obstruction of unclear etiology.
abstract: The differential diagnosis of upper 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 etiology. Superior mesenteric artery syndrome (SMAS) is a rare and controversial form of mechanical obstruction with just over 300 well-defined cases described in 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. A case of SMAS and a description of the syndrome is presented. The patient was managed conservatively and recovered without difficulty. One of the most difficult diseases to differentiate from SMAS is megaduodenum (intestinal pseudo-obstruction localized to the duodenum). Both entities present as obstruction with an unclear etiology. A reasonable approach to the diagnosis and management of upper intestinal obstruction (including figures, tables, and an algorithm), with emphasis on the above two diseases, is discussed.
authors: Department of Internal Medicine, USD School of Medicine, Rapid City.
authors: S
authors: S
authors: Fromm
authors: J M
authors: JM
authors: Cash
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D013478:Superior Mesenteric Artery Syndrome / Q000175:diagnosis / Q000628:therapy