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Hirai T, Kitada M, Hayashi Y, Monno I, Takagaki Y, Shimada K, Ogura Y, Fujii M, Konishi K, Nakagawa A, Koya D. Case report of superior mesenteric artery syndrome that developed in a lean type 2 diabetes patient and was associated with rapid body weight loss after sodium-glucose cotransporter 2 inhibitor administration. J Diabetes Investig 2020; 11:1359-1362. [PMID: 32020751 PMCID: PMC7477529 DOI: 10.1111/jdi.13228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 01/21/2020] [Accepted: 02/02/2020] [Indexed: 11/28/2022] Open
Abstract
A 58-year-old women who was diagnosed with type 2 diabetes 20 years earlier had been treated with antidiabetic medicines since she was aged 40 years. After sodium-glucose cotransporter 2 inhibitors administration, her bodyweight rapidly decreased from 40 to 30 kg over a period of 3 weeks. She had abdominal symptoms, including nausea, especially after a meal. On admission, physical examinations and laboratory data showed euglycemic ketoacidosis, dehydration and low insulin secretion levels. Additionally, abdominal contrast computed tomography showed the finding of superior mesenteric artery syndrome. This case urges caution, including rapid excessive bodyweight loss and euglycemic ketoacidosis, on the use of sodium-glucose cotransporter 2 for lean diabetes patients.
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Affiliation(s)
- Taro Hirai
- Department of Diabetology and EndocrinologyKanazawa Medical UniversityUchinadaJapan
| | - Munehiro Kitada
- Department of Diabetology and EndocrinologyKanazawa Medical UniversityUchinadaJapan
| | - Yoshihiro Hayashi
- Department of Diabetology and EndocrinologyKanazawa Medical UniversityUchinadaJapan
| | - Itaru Monno
- Department of Diabetology and EndocrinologyKanazawa Medical UniversityUchinadaJapan
| | - Yuta Takagaki
- Department of Diabetology and EndocrinologyKanazawa Medical UniversityUchinadaJapan
| | - Keiji Shimada
- Department of Diabetology and EndocrinologyKanazawa Medical UniversityUchinadaJapan
| | - Yoshio Ogura
- Department of Diabetology and EndocrinologyKanazawa Medical UniversityUchinadaJapan
| | - Mizue Fujii
- Department of Diabetology and EndocrinologyKanazawa Medical UniversityUchinadaJapan
| | - Kazunori Konishi
- Department of Diabetology and EndocrinologyKanazawa Medical UniversityUchinadaJapan
| | - Atsushi Nakagawa
- Department of Diabetology and EndocrinologyKanazawa Medical UniversityUchinadaJapan
| | - Daisuke Koya
- Department of Diabetology and EndocrinologyKanazawa Medical UniversityUchinadaJapan
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Lee CI, Wu YH. Pneumatosis intestinalis and pneumoretroperitoneum post steroid use in a patient with superior mesenteric artery syndrome. Am J Emerg Med 2019; 37:1993.e1-1993.e3. [PMID: 31262624 DOI: 10.1016/j.ajem.2019.06.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 06/23/2019] [Indexed: 11/19/2022] Open
Abstract
Pneumatosis intestinalis (PI) refers to the presence of gas within the wall of the small or large intestine. PI can be both asymptomatic and life-threatening. The patient was a 50-year-old man with previous cervical spine abscess and osteomyelitis post debridement 4 years ago, with a heroin abuse history. He presented with abdominal distension ongoing for 4 days and vomiting for 3 times with fluid content. Abdominal computed tomography revealed pneumatosis with pneumoretroperitoneum. A surgeon was contacted and antibiotic treatment was started. The patient was kept on nothing per os and intravenous fluid supply. A drainage tube was inserted into retroperitoneum space on the same day. Tracing back his history, our patient was discharged from the hospital recently with a diagnosis of superior mesenteric artery dyndrome (SMAS), hypersensitivity pneumonitis, and asbestosis with soft tissue pleural plaques and calcified pleural plaques. During the hospitalization period, hydrocortisone dexamethasone and methylprednisolone were prescribed for hypersensitivity pneumonitis. Steroid use and SMAS maybe the cause of PI. Finally, he was discharged 5 days later with a nasojejunal and drainage tubes and was arranged for OPD follow-up. PI can be asymptomatic or life-threatening, and patient management varies based on the clinical condition. Although in this case PI was found in the emergency department, a patient's past history of underlying disease and medication should be reviewed to find the most possible etiology.
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Affiliation(s)
- Ching-I Lee
- Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yen-Hung Wu
- Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Keighley J, Howlett D. Acute abdominal pain in an older patient. BMJ 2019; 365:l1337. [PMID: 31043375 DOI: 10.1136/bmj.l1337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Oliva-Fonte C, Fernández Rey C, Pereda Rodríguez J, González-Fernández AM. Wilkie´s syndrome. Rev Esp Enferm Dig 2017; 109:62-63. [PMID: 28100057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We report the case of a 14 year-old woman, who presents epigastric abdominal pain, abundant vomits and an important abdominal distension. Previously, she presented similar episodes. She has not any significant prior medical history. CT is performed and the imaging findings are consistent with Wilkie´s syndrome. Wilkie´s syndrome is a rare condition, that results from a intestinal obstruction caused by third portion duodenal compression between the abdominal aorta and the superior mesenteric artery. When the angle between both structures diminishes and the distance between the SMA and the aorta decreases (the most diagnostic value), duodenal obstruction occurs. Initially conservative management is adopted, but in some cases surgical treatment is necessary. Multislice CT has demonstrated an excellent diagnostic value when this entity is suspected. It provides multiplanar reconstructions, which are useful to measure the distance and the aortomesenteric angle and to rule out other possible etiologies.
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Foster C, Choudhary A. Severe malnutrition causing superior mesenteric artery syndrome in an adolescent with Triple A syndrome. J Pediatr Endocrinol Metab 2016; 29:1221-1224. [PMID: 27682707 DOI: 10.1515/jpem-2015-0373] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 08/29/2016] [Indexed: 12/26/2022]
Abstract
Triple A syndrome, formerly known as Allgrove syndrome (AS), is characterized by achalasia, alacrima and adrenal insufficiency. Here we report an adolescent male with adrenal insufficiency who developed severe malnutrition secondary to a delayed diagnosis of achalasia. The severe malnutrition in our patient led to superior mesenteric artery (SMA) obstruction syndrome. Severe malnutrition to the point of SMA syndrome has not been previously described in the literature in Triple A syndrome.
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Kamezaki H, Azemoto R, Yokosuka O, Fujimoto T, Obu M, Saito M, Yoshida Y, Koma Y, Maruyama H, Fujimori M. Suspicion of superior mesenteric artery syndrome in a patient with severe gastric dilatation after catheter ablation. Intern Med 2015; 54:605-9. [PMID: 25786450 DOI: 10.2169/internalmedicine.54.3276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Catheter ablation is a widely used treatment for atrial fibrillation. Gastric hypomotility due to periesophageal vagal plexus injury is a consequence of the extracardiac penetration of ablative energy. Some affected patients develop severe gastric dilatation requiring hospitalization. However, most previous reports have stated the cause of the subject's condition to be "unknown" or described the symptoms using obscure terms, such as "paralytic" or "gastroparesis." For example, one report stated that a few sites of severe gastric dilatation were secondary to "pyloric spasms;" however, no illustrations were provided in the paper. "Superior mesenteric artery syndrome" is a suspected cause of such dilatation.
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Affiliation(s)
- Hidehiro Kamezaki
- Department of Gastroenterology, Kimitsu Chuo Hospital, Japan; Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Japan
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Shin JI, Lee JS. Practical application of body mass index to various diseases associated with the nutcracker effect in children and adults. Surg Radiol Anat 2008; 30:527-8. [PMID: 18465080 DOI: 10.1007/s00276-008-0355-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Revised: 04/14/2008] [Accepted: 04/21/2008] [Indexed: 11/26/2022]
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Shin JI, Lee JS. Unexpected superimposition of nutcracker effect in various conditions: is it an unrecognized confounding factor? Comment on: Henoch-Schonlein purpura presenting duodenal involvement similar to superior mesenteric artery syndrome in a girl. (Eur J Pediatr. 2006 Sep 29; [Epub ahead of print]). Eur J Pediatr 2007; 166:1089-90. [PMID: 17180389 DOI: 10.1007/s00431-006-0382-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2006] [Accepted: 11/21/2006] [Indexed: 10/23/2022]
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Abstract
We present the case of a 19-year-old woman with feeding intolerance, due to superior mesenteric artery (SMA) syndrome, after weight loss experienced during basic military training. She had previous good health and presented with vomiting 8 weeks after starting military training. She had experienced a 16-pound (7 kg) weight loss during the course of training and was increasingly unable to tolerate meals, solids worse than liquids. Computed tomography of the abdomen with oral contrast revealed gastric and duodenal distention, with narrowing of the second portion of the duodenum at the SMA. A nasojejunal feeding tube was placed and she was given tube feedings. Weight increased and she eventually tolerated oral feedings. She completed military training and remains in good health. SMA syndrome is a rare cause of feeding intolerance, but can follow periods of acute weight loss, as is experienced by some basic military trainees.
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Affiliation(s)
- Christopher M Anderson
- Department of Surgery, Wilford Hall Medical Center, 59 MDW, 2200 Bergquist Avenue, Suite 1/MCSG, Lackland AFB, TX 78236, USA
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Arentz M, Kirkpatrick B, Casey A. Vomiting and rapid weight loss in a man with newly diagnosed HIV infection. Clin Infect Dis 2005; 41:1157-8, 1196-7. [PMID: 16173142 DOI: 10.1086/444504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Matthew Arentz
- Department of Internal Medicine, Fletcher Allen Health Care, Burlington, Vermont 05401, USA.
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Unal B, Aktaş A, Kemal G, Bilgili Y, Güliter S, Daphan C, Aydinuraz K. Superior mesenteric artery syndrome: CT and ultrasonography findings. Diagn Interv Radiol 2005; 11:90-5. [PMID: 15957095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE The purpose of the study was to describe computed tomography (CT) and ultrasonography findings in superior mesenteric artery syndrome (SMAS). MATERIALS AND METHODS The study was performed on 89 CT examinations. Ultrasonography was performed on 32 and barium study was performed on four of these subjects. Group A consisted of cases with one or more of the following complaints: postprandial epigastric pain, weight loss and vomiting. Group B consisted of the remaining cases. Cases who had all of the above-mentioned clinical findings and duodenal dilatation, to-and-fro barium movement and SMA indentation in barium study were diagnosed as having SMAS. Body mass index (BMI, kg/m2) was calculated. The distance between SMA and aorta, at the location where the duodenum passes from, was measured on CT and ultrasonography. The angle between SMA and aorta was measured on ultrasonography images. Group and gender differences were analyzed with t-test, the relationship between clinical and CT findings was analyzed with Mann Whitney U test and the relations between BMI-CT and CT-ultrasonography measurements were analyzed with Pearson coefficients. RESULTS Of 13 cases in Group A, 3 were diagnosed as SMAS. Eight of the cases showed gastric and/or duodenal dilatation. In 6 cases, antrum had an abnormally high location at portal hilus. In Group A, the SMA-aorta distance was 6.6 +/- 1.5 mm and the SMA-aorta angle was 18.7 +/- 10.7 degrees . In Group B, these values were 16.0 +/- 5.6 mm and 50.9 +/- 25.4 degrees , respectively (p < 0.001). Cut-off values between SMAS and Group B were 8 mm (100% sensitivity and specificity), and 22 degrees (42.8% sensitivity, 100 % specificity). CT and ultrasonography measurements (p < 0.001) and SMA-aorta distance and BMI (p=0.004) were significantly correlated. The SMA-aorta distance was significantly shorter in females (p=0.036). CONCLUSION Gastric and/or duodenal dilatation and a diminished SMA-aorta distance have a significant correlation with clinical symptoms of SMAS that include postprandial pain, vomiting and weight loss.
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Affiliation(s)
- Birsen Unal
- Department of Radiology, Kirikkale University School of Medicine, Kirikkale, Turkey.
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Neri S, Signorelli SS, Mondati E, Pulvirenti D, Campanile E, Di Pino L, Scuderi M, Giustolisi N, Di Prima P, Mauceri B, Abate G, Cilio D, Misseri M, Scuderi R. Ultrasound imaging in diagnosis of superior mesenteric artery syndrome. J Intern Med 2005; 257:346-51. [PMID: 15788004 DOI: 10.1111/j.1365-2796.2005.01456.x] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES We screened a cohort of subjects affected by various degree of dyspepsia to reveal if they presented a reduction of the aorto-mesenteric angle and to diagnose suspected cases of superior mesenteric artery (SMA) syndrome. DESIGN Controlled, prospective, study. SETTING Subjects were studied as outpatients. SUBJECTS The study investigated a total of 3622 subjects referred to our department by their general practitioners for dyspepsia and/or abdominal pain. Interventions. Abdominal ultrasonography with power colour Doppler, gastroduodenoscopy, hypotonic duodenography, contrast-enhanced spiral computerized tomography were performed. MAIN OUTCOME MEASUREMENT AND RESULTS: Color Doppler revealed a significant reduction of the SMA angle in 29 of 950 subjects; gastroscopy showed duodenal compressive pulsation in 14 of 29 patients and X-ray revealed compression of the third segment of the duodenum in 28 of 29 patients. CT confirmed the presence of a reduced angle and various degrees of duodenal compression in all patients. Ultrasonography and CT examinations gave overlapping results (P > 0.05) in diagnosing pathological aorto-mesenteric angle. CONCLUSION The authors believe that the incidence of reduced aorto-mesenteric angle and SMA syndrome might be underrated. Ultrasound power colour Doppler imaging is useful in epidemiological screening of reduced aorto-mesenteric angle to diagnose suspected cases of SMA syndrome.
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Affiliation(s)
- S Neri
- Department of Internal Medicine and Systemic Diseases, University of Catania, Catania, Italy.
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Ocal K, Canbaz H, Cağlikülekçi M, Yaylak F, Dirlik M, Aydin S. [A case of superior mesenteric artery syndrome following head trauma]. ULUS TRAVMA ACIL CER 2004; 10:264-7. [PMID: 15497068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
A twenty-four-year-old male patient developed a high level gastrointestinal obstruction during hospitalization in intensive care unit following a head trauma. He suffered from vomiting and weight loss and was unable to tolerate nasoenteral feeding. Barium radiographs revealed obstruction in the third portion of the duodenum. Upon failure of conservative treatment, laparotomy was performed, which showed compression and obstruction of the third portion of the duodenum by the superior mesenteric artery. A side-to-side duodenojejunostomy performed yielded complete relief of compression symptoms. The patient was symptomless in the sixth postoperative year. Although primary treatment of superior mesenteric artery syndrome is conservative, surgical treatment should be considered in unresponsive patients.
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Affiliation(s)
- Koray Ocal
- Department of General Surgery, Medicine Faculty of Mersin University, Mersin, Turkey.
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Rosa-Jiménez F, Rodríguez González FJ, Puente Gutiérrez JJ, Muñoz Sánchez R, Adarraga Cansino MD, Zambrana García JL. Duodenal compression caused by superior mesenteric artery: study of 10 patients. Rev Esp Enferm Dig 2003; 95:485-9, 480-4. [PMID: 12952509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
BACKGROUND the compression of the third portion of the duodenum by the superior mesenteric artery (aorto-mesenteric clamp) is a rare cause of abdominal pain. Its clinical appearance may range between an asymptomatic and accidental radiological finding and an acute duodenal ileus (superior mesenteric artery syndrome), which requires urgent surgical intervention. METHODS we revised all of the reports of upper gastrointestinal tract contrast-medium study (which included the duodenum) made in our hospital between May 1999 and April 2002. We analysed the case history of those patients with a radiological image compatible with aorto-mesenteric clamp. RESULTS of the 1280 studies analysed, 10 of them (0,78%) were compatible with an aorto-mesenteric clamp. The 10 patients were females whose mean age was 25,7 years (range 9-77) that consulted for different abdominal discomfort. The symptoms of the 9 youngest patients were not typical of duodenal obstruction and their evolution was favourable. In the eldest patient, the clinical data were compatible with a mesenteric superior artery syndrome, although a subsequent study showed the presence of a colon adenocarcinoma. CONCLUSIONS the aorto-mesenteric clamp is a rare radiological finding (<1 %) which does not always justify the supported clinical data. In our series, 9 cases were considered non-obstructive aorto-mesenteric clamps, although some of them showed pathogenical factors (scoliosis and thinness). The superior mesenteric artery syndrome should be considered as a diagnosis of exclusion after performing an adequate clinical study when the situation of the patient requires it.
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Affiliation(s)
- F Rosa-Jiménez
- Líneas de Procesos Generales del Adulto. Hospital Alto Guadalquivir. Andújar. Jaén, Spain.
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Abstract
STUDY DESIGN A retrospective report of three cases outlining upper intestinal obstruction as a rare complication following surgery for scoliosis. OBJECTIVE To present the clinical features, progression, and management of duodenal obstruction due to superior mesenteric artery compression after surgical treatment of scoliosis. SUMMARY OF BACKGROUND DATA Superior mesenteric artery or cast syndrome has been reported historically in the literature. Many causes are described, among which is the complication of the surgical and nonoperative treatment of scoliosis. METHODS Three adolescent patients were investigated for nausea and vomiting following surgical correction of scoliosis. RESULTS Contrast radiography confirmed extrinsic obstruction of the third part of the duodenum by the superior mesenteric artery in all three patients. They were jointly managed with the gastrointestinal surgeons. Two patients recovered with conservative treatments, but the third required operative intervention with a laparotomy. CONCLUSIONS Vomiting following surgery for scoliosis should be investigated thoroughly, as superior mesenteric artery syndrome carries significant morbidity, protracted hospital stay, and potential mortality.
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Affiliation(s)
- Mark A A Crowther
- Departments of Orthopaedics and General Surgery, Musgrove Park Hospital, Taunton, Somerset, United Kingdom.
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Abstract
An acute presentation of the superior mesenteric artery syndrome was diagnosed in a 13-year-old Chinese boy in whom no predisposing cause was found at surgery. Duodenogram combined with dynamic computed tomography, including 2-dimensional multiplanar reconstructions, was useful in confirming the diagnosis prior to definitive surgery.
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Affiliation(s)
- G C Ooi
- Department of Diagnostic Radiology, University of Hong Kong, Queen Mary Hospital, Hong Kong
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Cogliandolo A, Certo A, Bottari M, Gulino FM, Saitta FP. [Vascular compression syndrome of the duodenum. Diagnostic and therapeutic update]. Ann Ital Chir 1989; 60:531-5. [PMID: 2639610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Superior mesenteric artery syndrome is an uncommon clinical condition. A case of duodenal vascular compression and a review of the literature are reported in order to clarify the pathophysiology of the disease. Diagnostic values of hypotonic duodenography and angiography are emphasized. Although, the significance of long-term pH monitoring and gastric emptying for preoperative study and its importance in follow-up after the surgical treatment are evaluated.
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Battilana A, Crespi B, Rabughino G, Mosca D, Mettini L. [2 cases of duodenal vascular compression syndrome]. Minerva Med 1989; 80:815-20. [PMID: 2797473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- A Battilana
- Università degli Studi di Milano, Ospedale San Giuseppe, Cattedra di Patologia Speciale Chirurgica
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Chifan M, Strat V, Tîrcoveanu E, Cotea E, Georgescu S, Stanciu C. [Megaduodenum due to aortomesenteric shunt]. Rev Med Chir Soc Med Nat Iasi 1989; 93:599-601. [PMID: 2636760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Two new cases of megaduodenum by aortomesenteric shunt in young adults are presented. The role of some risk factors, the diagnostic and therapeutical elements are discussed, the importance of a thorough investigation of each case in view of individualizing the therapeutical management being underlined.
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Cremonte LG, Mantellini E. [An association of acute pancreatitis and intestinal infarct due to superior mesenteric artery occlusion]. Minerva Med 1989; 80:505-6. [PMID: 2473424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The clinical case of a 67-year-old woman admitted for abdominal pain whose interpretation created difficulties but which corresponded substantially to the pain encountered in intestinal occlusion associated with diabetes mellitus and increase in amylasemia is reported. After decrease, 48 hours after hospitalization, necropsy revealed extensive acute pancreatitis associated with infarction of the small bowel to occlusion of the superior mesenteric artery.
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Moral Turiel M, Dávila Muñoz PA, Ibáñez Agüir V, Abadés Alvarez J, Madrid Arias JL. [Tumors of the anterior mediastinum. Apropos of a case]. Rev Esp Anestesiol Reanim 1988; 35:49-51. [PMID: 3353554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Stupin VA, Vinokurov IL, Fedorov AV. [Rare variant of vascular compression of the duodenum]. Khirurgiia (Mosk) 1984:132-3. [PMID: 6513369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Del Valle Hernández E, Goyanes Martínez A, Muñiz González J. [Vascular compression of the duodenum]. Rev Esp Enferm Apar Dig 1984; 65:41-48. [PMID: 6701361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Uggeri G, Rumi A, Arcidiaco M, Pesenti A, Testone G. [Wilkie's syndrome: etiopathogenetic, clinical and therapeutic aspects of some cases we have seen]. Chir Ital 1981; 33:301-15. [PMID: 7261211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The Authors hold that for the onset of the clinical manifestations of the Wilchie's syndrome the contemporary appearance of 2 causes is necessary: the first is an anatomical variance of the organs comprising that particular anatomical location and the second being a pathological alteration taking place in one or more of these set organs. Moreover they suggest appropriate surgical procedure art at removing both causes that produced the disease.
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Beyer D, Horsch S, Bohr M, Schmitz T. [Roentgenographic findings of experimental bowel ischaemia is dogs following occlusion of the superior mesenteric artery (author's transl)]. ROFO-FORTSCHR RONTG 1980; 132:377-85. [PMID: 6450095 DOI: 10.1055/s-2008-1056582] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The results after ligation of the superior mesenteric artery in 17 dogs demonstrated, that a "gasless" abdomen and small bowel pseudo-obstruction are unspecific early roentgenographic findings and bowel-wall thickening with narrowed lumen and increased distance to neighbouring loops are a specific early roentgenographic plain-film findings of acute bowel ischemia following mesenteric vascular occlusion. Approximately 10 hours after ligation a combined distension of small and large bowel with dilatation and air-fluid levels is demonstrable as a sign of paralytic ileus with diffuse peritonitis without possibility of differentiation from other causes of this entity. Gas in the bowel wall, in the superior mesenteric vein and in the portal venous system is a late specific plain-film finding resulting from the invasion of gas-forming bacteria into the devitalized bowel wall with advanced gangrene and a sign of infaust prognosis. The results of the plain-film examinations are correlated to angiographic, clinical and laboratory findings, as well as to histology and bacteriology of the ischemic bowel segments.
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