ABSTRACT
Wilkie syndrome is an unusual form of high gastrointestinal obstruction resulting from compression of the duodenum between the abdominal aorta and the superior mesenteric artery (SMA). The conditions that cause this syndrome can be classified into five categories: severe wasting diseases, severe injuries, diseases, deformity or trauma to the spine, dietary disorders and posoperative state. The symptoms include nausea, vomiting, distention postprandrial, epigastric pain and weight loss. Barium meal and arteriography were used as diagnostic tools, now CT-angiography is being used and shown higher diagnostic sensitivity. The diagnostic criteria are: dilated duodenum, compression of the duodenum by the SMA and aortomesenteric angle <20 degrees. Patients with acute syndrome often respond to conservative treatment (decompression, correction of dehydration and electrolyte imbalance and nutrition support). Most of the patients with chronic syndrome require surgical intervention. Duodenojejunostomy is the most effective surgical option, with a success rate of 90%.
Subject(s)
Superior Mesenteric Artery Syndrome/therapy , Adult , Angiography , Anorexia Nervosa/complications , Anorexia Nervosa/diagnosis , Dehydration/therapy , Diagnostic and Statistical Manual of Mental Disorders , Duodenum/pathology , Humans , Male , Nutritional Support , Superior Mesenteric Artery Syndrome/diagnosis , Superior Mesenteric Artery Syndrome/surgery , Tomography, X-Ray ComputedABSTRACT
El Síndrome de Wilkie es una causa poco frecuente de obstrucción intestinal alta, resultante de la compresión del duodeno entre la aorta abdominal y la arteria mesentérica superior (AMS). Sus causas se pueden clasificar en cinco grupos: síndromes consuntivos, trastornos de la alimentación, postoperatorio, trauma severo y deformidades, enfermedades o traumatismos de la columna vertebral. Los síntomas incluyen náuseas, vómitos, pérdida ponderal, saciedad precoz, distensión abdominal y dolor epigástrico. Historicamente el estudio con bario y la arteriografía eran las pruebas diagnósticas utilizadas; más recientemente el angioTAC ha demostrado mayor sensibilidad. Los criterios diagnósticos son: duodeno dilatado, compresión duodenal por la AMS y ángulo aortomesentérico menor de 20 grados. Los pacientes con un cuadro agudo suelen responder al tratamiento conservador (descompresión, corrección de las alteraciones hidroelectrolíticas, apoyo nutricional); sin embargo aquellos con cuadros crónicos habitualmente requieren ser intervenidos. La duodenoyeyunostomía es el procedimiento de elección(tasa de éxito superior al 90%) (AU)
Wilkie syndrome is an unusual form of high gastrointestinal obstruction resulting from compression of the duodenum between the abdominal aorta and the superior mesenteric artery (SMA). The conditions that cause this syndrome can be classified into five categories: severe wasting diseases, severe injuries, diseases, deformity or trauma to the spine, dietary disorders and posoperativestate. The symptoms include nausea, vomiting, distention postprandrial, epigastric pain and weight loss. Bariummeal and arteriography were used as diagnostic tools, now CT-angiography is being used and shown higherdiagnostic sensitivity. The diagnostic criteria are: dilated duodenum, compression of the duodenum by the SMA and aortomesenteric angle <20 degrees. Patients with acute syndrome often respond to conservative treatment(decompression, correction of dehydration and electrolyte imbalance and nutrition support). Most of the patients with chronic syndrome require surgical intervention. Duodenojejunostomy is the most effective surgical option, with a success rate of 90% (AU)
