Description

Superior mesenteric artery (SMA) syndrome, also known as Wilkie's syndrome or mesenteric artery syndrome, is a rare condition characterized by compression or obstruction of the third part of the duodenum (the portion of the small intestine) by the superior mesenteric artery. This compression leads to various symptoms related to the gastrointestinal tract. Symptoms of SMA syndrome Superior mesenteric artery (SMA) syndrome, also known as Wilkie's syndrome or mesenteric artery syndrome, can present with various symptoms and signs related to the gastrointestinal tract. These can include: 1 Abdominal pain: The most common symptom of SMA syndrome is chronic or intermittent abdominal pain. The pain is typically located in the epigastric region (upper central abdomen) or the periumbilical area (around the belly button). The pain may be described as crampy, dull, or aching in nature and can worsen after eating. 2 Nausea and vomiting: SMA syndrome can cause nausea and episodes of vomiting. This can be related to the compression of the duodenum, which can lead to delayed or impaired passage of food through the digestive system. 3 Early satiety: Patients with SMA syndrome often experience a feeling of fullness or early satiety even after consuming small amounts of food. This can be due to the compression of the duodenum, which can impede the normal passage of food from the stomach to the small intestine. 4 Weight loss: Chronic or severe cases of SMA syndrome may result in unintentional weight loss. The compression of the duodenum can lead to inadequate intake of food and nutrients, contributing to weight loss. 5 Bloating and distension: Some individuals with SMA syndrome may experience abdominal bloating and distension. This can be associated with impaired digestion and slowed transit of food through the digestive system. 6 Acid reflux: SMA syndrome can sometimes cause symptoms of gastroesophageal reflux disease (GERD), such as heartburn and regurgitation of stomach acid into the throat. The compression on the duodenum can affect the normal flow of stomach contents, leading to reflux symptoms. It's important to note that the symptoms of SMA syndrome can vary in severity and presentation. Some individuals may experience more severe symptoms, while others may have milder manifestations. The condition can be challenging to diagnose due to its rarity and the similarity of symptoms to other gastrointestinal disorders. If you suspect SMA syndrome or are experiencing persistent or worsening symptoms, it's important to consult a healthcare professional for a thorough evaluation and appropriate management. Diagnosis of SMA syndrome The diagnosis of Superior Mesenteric Artery (SMA) syndrome involves a combination of clinical assessment, imaging studies, and exclusion of other potential causes of symptoms. The following approaches are commonly used in the diagnostic process: 1. Medical history and physical examination: Your healthcare provider will review your medical history and inquire about your symptoms, including abdominal pain, weight loss, and eating patterns. A physical examination may be conducted to assess for signs such as abdominal tenderness or distension. 2. Imaging studies: a. Upper gastrointestinal (GI) series/barium swallow: This test involves swallowing a contrast material (barium) that coats the esophagus, stomach, and duodenum. X-ray images are then taken to observe the anatomy and evaluate any potential obstruction or narrowing of the duodenum. b. Computed tomography (CT) scan: A CT scan provides detailed cross-sectional images of the abdomen. It can help visualize the relationship between the superior mesenteric artery and the duodenum, detect any compression or obstruction, and assess other potential causes of symptoms. c. Magnetic resonance imaging (MRI): MRI scans use magnetic fields and radio waves to produce detailed images of the body. MRI can provide information about the anatomy and possible compression of the duodenum by the superior mesenteric artery. d. Upper endoscopy: In some cases, an upper endoscopy may be performed to directly visualize the duodenum and rule out other conditions. During this procedure, a flexible tube with a camera (endoscope) is inserted through the mouth and into the digestive tract. e. Measurement of angles and distances: Specific measurements of angles and distances on imaging studies can aid in the diagnosis of SMA syndrome. These measurements include the aortomesenteric angle (the angle between the abdominal aorta and the superior mesenteric artery) and the superior mesenteric artery–duodenum distance. f. Exclusion of other causes: It's essential to exclude other potential causes of similar symptoms, such as gastric outlet obstruction, peptic ulcer disease, or other gastrointestinal disorders. Additional tests or consultations may be necessary to rule out these conditions.