A case of superior mesenteric artery syndrome due to peritoneal seeding in a colon cancer patient / 대한내과학회지

Small bowel obstruction can develop from adhesions, hernias, and less frequently from tumors. Superior mesenteric artery (SMA) syndrome is an uncommon cause of small bowel obstruction. We experienced a case of SMA syndrome caused by peritoneal seeding from colon cancer. A 57-year-old woman presented with nausea, post-prandial vomiting, and weight loss. She had been receiving palliative chemotherapy for 12 months to treat colon cancer with peritoneal seeding. Abdominal computed tomography and a small bowel series revealed typical findings of SMA syndrome. As conservative treatment including nutritional support and positional change was ineffective, she was treated surgically. An adhesive mass compressing the SMA and duodenum was found at the third portion of the duodenum. The pathologic diagnosis was metastatic adenocarcinoma of colorectal origin. Adhesiolysis and duodenojejunostomy relieved her symptoms. This case shows that SMA syndrome can develop via peritoneal seeding in cancer patients.

A Case of a Gastric Bezoar Combined with Superior Mesenteric Artery Syndrome / 대한소화기내시경학회지

Superior mesenteric artery syndrome is caused by compression of the third part of the duodenum between the superior mesenteric artery (SMA) and the aorta. Recently, we experienced a case of a gastric bezoar combined with SMA syndrome. A 58-year-old man presented with upper abdominal pain, bloating and weight loss of 5 kg. An endoscopic examination identified a huge gastric bezoar. The bezoar was broken and fragmented into small pieces using an argon plasma coagulator and endoscopic snare catheter. Hypotonic duodenography showed a longitudinal linear band that was presumed to be a vascular impression of the third portion of the duodenum and contrast-enhanced spiral CT showed a reduced distance of 8.4 mm but a normal angle of 38.5degrees between the arota and the SMA. A second endoscopic examination demonstrated prominent pulsations that compressed the duodenal wall at the third portion. Luminal expansion with full inflation of air was not attempted under endoscopy.

SMA Syndrome after Corrective Surgery of Thoracic Kyphoscoliosis: A Case Report / 대한척추외과학회지

Superior mesenteric artery (SMA) syndrome is a rare condition that results from an extrinsic compression of the third portion of the duodenum, between the SMA and the aorta. The symptoms for the condition consist of abdominal pain and recurrent vomiting, caused by ileus, and can be followed by an electrolyte imbalance and nutrient deficiency. SMA syndrome can follow surgical correction of a spinal deformity, as the aorta migrates forward as the degree of the lumbar lordosis increases, and the retroperitoneal fat tissue decreases, during perioperative abstinence. Any symptoms suggestive of SMA syndrome, after correction of a spinal deformity, should be investigated, as SMA syndrome carries a prolonged hospital stay, with the potential for mortality. An 11 year 10 month old boy, who underwent correction for thoracic kyphoscoliosis, developed postoperative abdominal distension, pain and bilious vomiting. An upper gastrointestinal contrast study revealed SMA syndrome, which required a laparotomy.

Superior Mesenteric Artery Syndrome: Report of three cases

Superior mesenteric artery syndrome is a rare clinical disease in Korea. The authors experienced three cases of the superior mesenteric artery syndrome. All of patients complained of continuos bilious vomiting, epigastric discomfort, epigastric fullness, and weight loss. The superior mesenteric artery syndrome was diagnosed preoperative, by using physical examination, gastrofiberscopy, upper gastrointestinal series, abdominal computerized tomography (CT), and spiral CT angiogram. We performed a Roux-en-Y duodenojejunostomy. We measured the angle between the aorta and that superior mesenteric artery by using a spiral CT angiogram. The angles were 10o, 11o, and 11o. Postoperatively they were improved. A spiral CT angiogram was a noninvasive method of diagnosing the superior mesenteric artery syndrome compared with a femoral angiography. The Roux-en-Y duodenojejunostomy was the proper method of treatment for the superior mesenteric artery syndrome.