title: [Vomiting, abdominal pain and weight loss with an acquired anatomical cause: superior mesenteric artery syndrome].
abstract: Superior mesenteric artery syndrome (SMAS) is a rare and acquired anatomical condition characterized by vomiting, abdominal distension, weight loss and postprandial distress due to compression of the transverse portion of the duodenum between the superior mesenteric artery (SMA) and aorta, which causes duodenal outflow problems. We report a case series of three patients with SMAS. Diagnosis of the syndrome was made by augmenting a high degree of suspicion with repeat gastroscopies, CT scans and hypotonic duodenal contrast series showing compression of the horizontal part of the duodenum located between the vessels specified above. Medical therapy for the condition is aimed at nutritional rehabilitation so that weight gain results in relief of the obstruction. In each of our patients, surgical treatment was necessary during which the ligament of Treitz was divided and a side-to-side duodenojejunostomy was performed. In all, the weight loss seen preoperatively has been corrected.
authors.affiliation: Alysis Zorggroep, locatie Rijnstate, afd. Maag-, Darm- en Leverziekten, Arnhem, the Netherlands. jvrolijk@alysis.nl
authors.forename: Jan Maarten
authors.initials: JM
authors.lastname: Vrolijk
authors.forename: Paul A M
authors.initials: PA
authors.lastname: Rosekrans
authors.forename: P Ted
authors.initials: PT
authors.lastname: den Hoed
authors.forename: Rob Th J
authors.initials: RT
authors.lastname: Ouwendijk
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013478:Superior Mesenteric Artery Syndrome / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome; D014839:Vomiting / Q000175:diagnosis / Q000209:etiology*; D015431:Weight Loss; D055815:Young Adult