Ultrasound imaging in diagnosis of superior mesenteric artery syndrome.
OBJECTIVE
We screened a cohort of subjects affected by various degree of dyspepsia to reveal if they presented a reduction of the aorto-mesenteric angle and to diagnose suspected cases of superior mesenteric artery (SMA) syndrome.


METHODS
Controlled, prospective, study.


METHODS
Subjects were studied as outpatients.


METHODS
The study investigated a total of 3622 subjects referred to our department by their general practitioners for dyspepsia and/or abdominal pain. Interventions. Abdominal ultrasonography with power colour Doppler, gastroduodenoscopy, hypotonic duodenography, contrast-enhanced spiral computerized tomography were performed. MAIN OUTCOME MEASUREMENT AND RESULTS: Color Doppler revealed a significant reduction of the SMA angle in 29 of 950 subjects; gastroscopy showed duodenal compressive pulsation in 14 of 29 patients and X-ray revealed compression of the third segment of the duodenum in 28 of 29 patients. CT confirmed the presence of a reduced angle and various degrees of duodenal compression in all patients. Ultrasonography and CT examinations gave overlapping results (P > 0.05) in diagnosing pathological aorto-mesenteric angle.


CONCLUSIONS
The authors believe that the incidence of reduced aorto-mesenteric angle and SMA syndrome might be underrated. Ultrasound power colour Doppler imaging is useful in epidemiological screening of reduced aorto-mesenteric angle to diagnose suspected cases of SMA syndrome.
Neri
S
S
Department of Internal Medicine and Systemic Diseases, University of Catania, Catania, Italy. sergio.neri4@tin.it
Signorelli
S S
SS
Mondati
E
E
Pulvirenti
D
D
Campanile
E
E
Di Pino
L
L
Scuderi
M
M
Giustolisi
N
N
Di Prima
P
P
Mauceri
B
B
Abate
G
G
Cilio
D
D
Misseri
M
M
Scuderi
R
R
D015746:Abdominal Pain / Q000000981:diagnostic imaging; D000328:Adult; D001011:Aorta / Q000000981:diagnostic imaging / Q000473:pathology; D004415:Dyspepsia / Q000000981:diagnostic imaging; D005260:Female; D005773:Gastroscopy; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000473:pathology; D011187:Posture; D011446:Prospective Studies; D013478:Superior Mesenteric Artery Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology; D036542:Tomography, Spiral Computed; D018615:Ultrasonography, Doppler, Color