Transcript Slide 1

Superior Mesenteric Artery Syndrome
By:
Ali Azizi
Alborz Hedayati
Superior Mesenteric Artery Syndrome
Male adult. Celiac trunk (ct); left gastric artery (lga); splenic artery (sa);
common hepatic artery (cha); superior mesenteric artery (sma)
Superior Mesenteric Artery Syndrome
Superior Mesenteric Artery Syndrome
Compression of 3rd portion of duodenum between the aorta and superior
mesenteric artery (SMA)
Females >males
Pathophysiology
Narrowing of angle between SMA and aorta
SMA usually forms an angle of 45 degrees with the aorta
Superior Mesenteric Artery Syndrome
Etiologies
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Prolonged bed rest in supine position (body cast, whole-body burns, surgery)
Substantial and, frequently, rapid weight loss
Anorexia nervosa or malnutrition
Loss of abdominal muscle tone (as in pregnancy)
May be congenital
Seen in those with asthenic build
Exaggerated lumbar lordosis
Superior Mesenteric Artery Syndrome
Clinical findings
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Epigastric pain
Nausea
Repetitive vomiting
Abdominal cramping
Typically findings are worst in supine position and may be relived by
changing to the prone or left lateral decubitus positions
6. Associated with a higher than normal incidence of peptic ulcer disease and
hyperchlorhydria
Superior Mesenteric Artery Syndrome
Imaging findings
Usually requires upper GI or CT of abdomen for diagnosis
Megaduodenum
Pronounced dilation of 1 st and 2nd portion of
duodenum and frequently stomach
Best seen in supine position
Compression of duodenum between aorta and SMA
.Upper gastrointestinal tract series shows dilatation of second portion of duodenum
.)Upper gastrointestinal series showing duodenal dilation (white arrow
Axial CT scans of the upper abdomen show a
)D( dilated 2nd portion of the duodenum
just proximal to a narrowed segment of the 3rd
)green arrow( portion of the duodenum
compressed between the superior mesenteric
and the aorta (black arrow ))red arrow( artery
SMA>red
Computed tomography shows narrowing between
superior mesenteric artery and aorta, with dilatation of
second portion of duodenum.
Abdominal and pelvic CT scan showing duodenal compression (black arrow) by
the abdominal aorta and the superior mesenteric artery
Thank you