Superior mesenteric artery syndrome: where do we stand today?
BACKGROUND
Most data on large studies of superior mesenteric artery syndrome (SMAS) were published over 30 years ago. New studies are needed so that current medical progress can influence SMAS diagnosis and improve therapeutic outcomes.


METHODS
This study was conducted to report the clinical features and outcomes of SMAS. From January 2000 to December 2009, 80 cases (53 females, median age 28 years) of SMAS were collected retrospectively from seven university hospitals in South Korea.


RESULTS
The median body mass index at diagnosis was 17.4 kg/m(2), with a range of 10-22.1. Forty (50 %) of the 80 SMAS patients had co-morbid conditions including mental and behavioral disorders, infectious disorders, and disorders of the nervous system (21.3, 12.5, and 11.3 %, respectively). Computerized tomography was most commonly (93.8 %) used to diagnose SMAS. The overall medical management success and recurrence rates were 71.3 and 15.8 %, respectively. Surgical management had a high 92.9 % (13/14) success rate. The most common surgical procedure for SMAS was laparoscopic duodenojejunostomy.


CONCLUSIONS
This is the largest case series to document the clinical features and changes in diagnostic modalities, medical and surgical managements, and their outcomes in SMAS patients. Laparoscopic duodenojejunostomy is the preferred surgical procedure when medical management of the disease fails.
Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University Hospital, Seoul, South Korea.
Tae Hee
TH
Lee
Joon Seong
JS
Lee
Yunju
Y
Jo
Kyung Sik
KS
Park
Jae Hee
JH
Cheon
Yong Sung
YS
Kim
Jae Young
JY
Jang
Young Woo
YW
Kang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013478:Superior Mesenteric Artery Syndrome / Q000175:diagnosis* / Q000628:therapy*; D055815:Young Adult