title: Assessment of duodenal circular drainage in treatment of superior mesenteric artery syndrome.
abstract: OBJECTIVE
  To assess the clinical value of duodenal circular drainage for superior mesenteric artery syndrome (SMAS).
  
  
  METHODS
  Forty-seven cases of SMAS were treated with duodenal circular drainage from 1959 to 2001. Clinical data were analyzed retrospectively.
  
  
  RESULTS
  In this group, good effects were achieved in 39 cases treated with duodenal circular drainage after 2-15 years of follow-up. The other eight cases were first treated with anterior repositioning of the duodenum (two cases), duodenojejunostomy (five cases), subtotal gastrectomy and billroth II gastrojejunostomy (one case), but vomiting was not relieved until duodenal circular drainage was performed again. A follow-up study of 8-10 years revealed satisfactory results in these eight patients.
  
  
  CONCLUSIONS
  In SMAS, if the reversed peristalsis is strong and continuous, and vomiting occurs frequently, the symptom can not be relieved even if the obstruction of duodenum is removed surgically. The key treatment is the relief of reversed peristalsis. The duodenal circular drainage can resolve the drainage direction of duodenal content, thus relieving the symptom of vomiting.
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, Heilongjiang Province, China.
authors.forename: Wei-Liang
authors.initials: WL
authors.lastname: Yang
authors.forename: Xin-Chen
authors.initials: XC
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004322:Drainage / Q000379:methods*; D004386:Duodenum / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D013478:Superior Mesenteric Artery Syndrome / Q000000981:diagnostic imaging / Q000601:surgery*