SMA Syndrome – Wait & Nurture
https://doi.org/10.47836/mjmhs.18.6.47
- Author:
Shier Khee Saw
1
,
2
,
3
;
Ahmad Zuraimi Zulkifli
3
;
Chandran Nadarajan
1
,
4
;
Jien Yen Soh
1
,
2
;
Mohd Azem Fathi Mohammad Azmi
1
,
2
;
Syed Hassan Syed Abd Aziz
1
,
2
;
Michael Pak-Kai Wong
1
,
2
Author Information
1. School of Medical Sciences, Universiti Sains Malaysia, 16150 Kelantan Malaysia&
2. Department of Surgery, Hospital Universiti Sains Malaysia, 16150 Kelantan, Malaysia&
3. Department of Surgery, Hospital Raja Perempuan Zainab II, 15586 Kelantan, Malaysia
4. Department of Radiology, Hospital Universiti Sains Malaysia, 16150 Kelantan, Malaysia
- Publication Type:Case Reports
- Keywords:
Duodenal obstruction, Intestinal obstruction, Mesenteric duodenal compression syndrome, Superior mesenteric artery syndrome
- From:Malaysian Journal of Medicine and Health Sciences
2022;18(No.6):353-355
- CountryMalaysia
- Language:English
-
Abstract:
Superior mesenteric artery (SMA) syndrome is rare with the common presentation of megaduodenum from entrapment of the third part of the duodenum (D3) by the SMA. We present a case report of a thin, fit 16-year-old boy,
active smoker complaining of generalized colicky abdominal pain associated with persistent postprandial vomiting.
Small bowel study demonstrated partial duodenal obstruction from compression of the third part of the duodenum
by the SMA. Computed tomography of the abdomen shows an aorto-mesenteric angle of 13 degrees with aorto-mesenteric distance of 0.32 cm, indicating SMA syndrome. His symptoms resolved spontaneously with watchful waiting
and nutritional care plan. The success was contributed to restoring the fat cushion around the SMA, hence, widening
the aorto-mesenteric angle. In conclusion, watchful waiting with a nutritional care plan is a feasible initial strategy
in the approach to SMA syndrome. However, should this strategy be unsuccessful, the choice of surgical treatment
is duodenojejunostomy.
- Full text:11.2022my1397.pdf
