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Abstract Superior mesenteric artery syndrome (SMAS) is a rare and unpredictable complication after correction spine surgery for adolescent idiopathic scoliosis (AIS). The management of this condition is poorly investigated, with controversial outcomes. This investigation systematically reviewed current evidence on pathogenesis, risk factors, management, and outcomes of SMAS following correction spine surgery for AIS. The present systematic review was conducted according to the 2020 PRISMA statement. All the included investigations reported SMAS presentation following scoliosis correction surgery in AIS. 29 articles with 61 eligible patients were included in this review. The mean age of the patients was 15.8 ± 7.2 years. The mean weight was 45.3 ± 8.0 kg, the mean height 159.6 ± 13.6 cm, and the mean BMI 16.5 ± 2.9 kg/m2. The mean duration of the treatment for SMAS was 21.6 ± 10.3 days. The mean interval between spine surgery and symptoms of SAMS was 69 days, with high between-studies variability (3 days to 4 years). Prompt identification of risk factors and an early diagnosis are necessary to manage SMAS and reduce the risk of complications. Additional investigations are required to establish risk factors and diagnostic criteria. Level of evidence Level IV, systematic review.

Superior mesenteric artery syndrome (SMAS) is a rare and unpredictable complication after correction spine surgery for adolescent idiopathic scoliosis (AIS). The management of this condition is poorly investigated, with controversial outcomes. This investigation systematically reviewed current evidence on pathogenesis, risk factors, management, and outcomes of SMAS following correction spine surgery for AIS. The present systematic review was conducted according to the 2020 PRISMA statement. All the included investigations reported SMAS presentation following scoliosis correction surgery in AIS. 29 articles with 61 eligible patients were included in this review. The mean age of the patients was 15.8 ± 7.2 years. The mean weight was 45.3 ± 8.0 kg, the mean height 159.6 ± 13.6 cm, and the mean BMI 16.5 ± 2.9 kg/m2. The mean duration of the treatment for SMAS was 21.6 ± 10.3 days. The mean interval between spine surgery and symptoms of SAMS was 69 days, with high between-studies variability (3 days to 4 years). Prompt identification of risk factors and an early diagnosis are necessary to manage SMAS and reduce the risk of complications. Additional investigations are required to establish risk factors and diagnostic criteria. Level of evidence Level IV, systematic review. [ABSTRACT FROM AUTHOR]

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Superior mesenteric artery (SMA) syndrome, also known as Wilkie's syndrome, is a rare disease presenting as an acute abdomen. It has a clinical presentation similar to intestinal obstruction and is often missed during diagnosis. Reduced weight leading to loss of fat pad between SMA and aorta is the main pathophysiology. Diagnosis is made through barium meal and CT scan. Conservative management remains the treatment of choice; however, surgery is opted for in refractory cases. Key Clinical Message: Superior mesenteric artery (SMA) syndrome, also known as Wilkie's syndrome, is a rare disease presenting as an acute abdomen with clinical features similar to intestinal obstruction. This is a case of SMA syndrome in an adult male with a decrease in aortomesenteric angle, with no predisposing condition. [ABSTRACT FROM AUTHOR]

Abstract Superior mesenteric artery (SMA) syndrome, also known as Wilkie's syndrome, is a rare disease presenting as an acute abdomen. It has a clinical presentation similar to intestinal obstruction and is often missed during diagnosis. Reduced weight leading to loss of fat pad between SMA and aorta is the main pathophysiology. Diagnosis is made through barium meal and CT scan. Conservative management remains the treatment of choice; however, surgery is opted for in refractory cases. Key Clinical Message Superior mesenteric artery (SMA) syndrome, also known as Wilkie's syndrome, is a rare disease presenting as an acute abdomen with clinical features similar to intestinal obstruction. This is a case of SMA syndrome in an adult male with a decrease in aortomesenteric angle, with no predisposing condition.

The rare pathological condition known as superior mesenteric artery (SMA) (Wilkie) syndrome arises when the third part of the duodenum experiences constriction due to compression between the aorta and the proximal segment of the SMA. The main complaints are nausea, vomiting, epigastric pain, and bloating with significant weight loss. Reported cases of this syndrome have been observed in patients who have scoliosis, suffered burns, led sedentary lifestyles, or experienced unexplained weight loss. In cases where there is unexplained rapid weight loss and recurrent obstructive findings that deviate from common causes, clinicians should include SMA syndrome in their differential diagnosis. This article presents a case of SMA syndrome, which has long affected the patient’s quality of life due to diagnostic difficulties, and discusses the disease’s diagnosis and management. [ABSTRACT FROM AUTHOR]

Superior mesenteric artery syndrome also known as Wilkie's syndrome (WS) and Nutcracker syndrome (NCS) are 2 rare vascular syndromes characterized by the reduction of the aortomesenteric space. In the WS the reduction of the aortomesenteric angle leads to compression of the third portion of the duodenum. In the NCS the reduced aortomesenteric space usually causes a left renal vein (LVR) entrapment and the clinical presentation is a left flank pain, micro/macrohematuria and proteinuria. Arterial hypertension can be an unusual manifestation of the NCS. Herein, we describe the case of a 37-year-old woman with a history of breast cancer and abdominal subocclusion, with a recent onset of arterial hypertension whose enhanced computed tomography (CT) showed a reduced angle between the abdominal aorta and superior mesenteric artery with the CT findings of both the WS and NCS.

Superior mesenteric artery (SMA) passes over the third part of duodenum and can cause its obstruction when the aorto-mesenteric angle is hyper acute. Although the condition is rare, the diagnosis can be made using radiography and the treatment consists of division of ligament of Treitz and duodenojejunostomy. We present a case of SMA syndrome in an elderly lady, who was managed successfully with surgery. [ABSTRACT FROM AUTHOR]

Objective: to describe the clinical presentation, diagnosis, and surgical treatment of a patient with superior mesenteric artery syndrome or Wilkie syndrome combined with the nutcracker syndrome or left renal vein compression syndrome in a tertiary referral center in a Latin American country. Case description: a 25-yearold male patient from the United States who attended for a year of weight loss and intestinal obstruction episodes of unknown etiology after multiple imaging studies. Endoscopic studies were performed without findings. While in the recovery room, he developed abdominal pain requiring admission to the emergency service. The CT enterography showed dilation of the colon loops and small intestine with a decrease of the aortomesenteric (AOM) angle and the gastrointestinal series with the filiform passage of the contrast medium. Conservative management was attempted as initial therapy with intolerance to enteric nutritional support. Finally, we initially opted for surgical treatment, with a slow recovery process, but in the end, with a resolution of symptoms and weight gain. Conclusion: Wilkie syndrome is a rare disease and a diagnostic challenge in patients with weight loss and abdominal pain. We described a superior mesenteric artery compression case in which diagnosis was achieved with multiple diagnostic strategies and complete resolution after surgical treatment. The decreased aortomesenteric angle may compress the superior mesenteric artery and the left renal vein. In this case, it resulted in a combined Wilkie and nutcracker syndrome. [ABSTRACT FROM AUTHOR]

Superior mesenteric artery (SMA) syndrome causes duodenal obstruction between the SMA and aorta, which culminates into bowel obstruction. Meanwhile, nutcracker syndrome (NCS) involves left renal vein compression between the aorta and SMA, categorized by the compression site. We present a 15-year-old female with no prior medical or surgical history who displayed early signs of the rarely coexisting SMA and nutcracker phenomena, which were managed symptomatically along with nutritional support to reach her optimal body mass index., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Review Board, College of Medicine, Majmaah University, Saudi Arabia issued approval Iec/case/MU/234/. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Almunifi et al.)

Introduction: Wilkie syndrome is a rare cause of upper gastrointestinal tract obstruction, it is characterized by a decrease in the aorto-mesenteric angle that results in a compression of the third portion of the duodenum causing high obstructive symptoms. Case Report: We present the case of a 64-year-old woman, with a history of abdominal pain, heartburn, early satiety, and intolerance to the oral route, in whom initial studies showed esophagitis, but in whom symptoms did not improve with the classic treatment for peptic acid disease, additional imaging studies suggested Wilkie syndrome. Discussion and Conclusion: It is a pathology that must be known and suspected in patients with a history of weight loss, marked intolerance to oral intake, and lack of treatment response. [ABSTRACT FROM AUTHOR]

Superior mesenteric artery syndrome (SMAS) is a rare cause of upper intestinal obstruction. This occurs due to duodenal compression between the superior mesenteric artery and the aorta. Anatomical alterations, eating disorders, after some surgical procedures, and trauma are frequent causes of this rare syndrome. Diabetes is a highly prevalent disease that can cause gastroparesis in up to 12 %. Its association with SMAS is extremely rare and challenging to identify. A 32-year-old man experienced nausea and vomiting after diagnosis and treatment for type II diabetes. He was treated for diabetic gastroparesis for 2 years without improvement until he lost 40 kg of weight. After imaging studies, a distance between the superior mesenteric artery and the aorta of 5.3 mm and an angle of 17 degrees were detected, corroborating the diagnosis of SMAS syndrome. Due to medical failure, surgical treatment via duodenojejunostomy was performed. Diabetes is a very prevalent disease in the world population that can cause gastrointestinal symptoms. In our patient, diabetic gastroparesis delayed the diagnosis of SMAS until severe symptoms of upper intestinal obstruction and significant weight loss occurred. In our patient, due to medical failure, surgical treatment significantly improved his symptoms and stopped his weight loss. Superior mesenteric artery syndrome is a rare syndrome, and challenging to differentiate from diabetic gastroparesis. Delays in management may result in excessive weight loss. Surgical treatment can improve symptoms and weight loss. • Superior mesenteric artery syndrome (SMAS) is a rare cause of upper intestinal obstruction. • Diabetes is a highly prevalent chronic disease, and its association with SMAS is exceptionally rare. • Diabetic gastroparesis makes the diagnosis of intestinal syndromes such as SMAS challenging. • Delaying the diagnosis of SMAS can lead to significant weight loss, and surgical treatment could be a good treatment option. • We present a rare case of SMAS in a type II diabetic patient misdiagnosed with gastroparesis with significant weight loss. [ABSTRACT FROM AUTHOR]

Superior mesenteric artery syndrome is a rare vascular compression syndrome in which the duodenum is compressed between the aorta and the overlying superior mesenteric artery. This condition is often chronic and secondary to cachexia. It can trigger further weight loss due to the subsequent proximal intestinal obstruction, causing a positive feedback loop. We report a case of acute presentation of superior mesenteric artery syndrome, complicated by gastric necrosis and treated surgically using the principles of a novel bariatric procedure., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Talboom et al.)

Copyright of Revista de Gastroenterología del Perú is the property of Sociedad de Gastroenterologia del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• Wilkie's syndrome (WS) is a rare but impairing condition. • WS is defined by an aorto-mesenteric artery angle <25° or an aorto-mesenteric distance of <8 mm. • Conservative approaches aim at restoring the correct aorto-mesenteric artery angle. • Surgical approaches aim at bypassing the functional duodenal obstruction. • The overall WS outcome is good in 80–90% of cases. Wilkie's syndrome (WS), also known as superior mesenteric artery syndrome, is a rare clinical entity caused by compression of the horizontal (third) part of the duodenum between the superior mesenteric artery and the abdominal aorta leading to duodenal obstruction. We report a case of a 16 years girl with long-term history of spontaneous vomiting and self-induced vomiting, also suffering from recurrent retrosternal pain, weight loss and thus reduced quality of life. Contrast intestinal series showed a large axial hernia which was laparoscopically reduced and treated by hiatoplasty and anterior hemifundoplication. After initial relief, recurrent postprandial nausea and vomiting reoccurred 4 weeks postoperatively. Abdominal MRI study revealed findings compatible with WS. After endoscopic exclusion of an anatomical duodenal lumen stenosis, she was successfully treated by duodeno-jejunostomy with a favorable outcome. WS might be hidden behind presumably more evident diagnoses such as bulimia, significant axial hernia and gastro-esophageal reflux disease in patients with recurred vomiting, abdominal pain and weight loss. The rare clinical entity of a WS necessitates a targeted diagnostic evaluation and therapy. Clinical details, diagnostic studies and treatment are discussed here. [ABSTRACT FROM AUTHOR]

Superior mesenteric artery syndrome is a very uncommon disorder in which acute angulation of superior mesenteric artery (SMA) at its origin from aorta results in compression of the third part of the duodenum leading to partial or complete obstruction of the duodenum. Other terminologies for this condition are Cast syndrome, Wilkie syndrome, arteriomesenteric duodenal obstruction, and chronic duodenal ileus.1 The disease is extremely rare in the pediatric population. Here we report a case of SMA syndrome in an 11 year old boy who was admitted with hepatitis, subsequently developed primary peritonitis and during his admission at the hospital he developed SMA syndrome. The case is being reported for its extreme rarity, to highlight the role of imaging in establishing the diagnosis and to review the literature in the subject.

Superior mesenteric artery (SMA) syndrome refers to the constellation of symptoms that are associated with intermittent obstruction of the duodenum due to vascular compression. We present a case of SMA-like syndrome related to variant mesenteric venous drainage in the setting of normal aortomesenteric angle (AMA) and borderline reduced aortomesenteric distance (AMD). [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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%).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

Introduction The Superior Mesenteric Artery Syndrome (SMAS) is a rare form of intestinal obstruction. The diagnosis is based on findings from imaging studies, including vascular compression of the duodenum by the SMA and can be associated with duodenal dilatation. Presentation of case We report a case of a patient with SMAS and recurrent episodes of intestinal obstruction, which was successfully treated by laparoscopic duodenojejunostomy. Discussion The initial treatment is usually conservative for patient’s clinical improvement. Surgery is indicated when conservative treatment fails as well for patients with recurrent symptoms. Minimal invasive surgery might be a good approach, specially in patients who suffers from this disease and currently are in depleted health conditions. Conclusion The procedure herein demonstrated may be considered safe and resolutive, with good visualization of structures, relative short surgical time and fast post-operative recovery. [ABSTRACT FROM AUTHOR]

Copyright of Gefaesschirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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%. [ABSTRACT FROM AUTHOR]

We described three cases of superior mesenteric artery (SMA) syndrome, also known as Wilkie's syndrome, chronic duodenal ileus, or cast syndrome. This syndrome occurs when the third portion of the duodenum is compressed between the SMA and the aorta. The major risk factors for development of SMA syndrome are rapid weight loss and surgical correction of spinal deformities. The clinical presentation of SMA syndrome is variable and nonspecific, including nausea, vomiting, abdominal pain, and weight loss. The diagnosis is based on endoscopic, radiographic and tomographic findings of duodenal compression by the SMA. The treatment of SMA syndrome is aimed at the precipitating factor, which usually is related to weight loss. Therefore, conservative therapy with nutritional supplementation is the initial approach, and surgery is reserved for those who do not respond to nutritional therapy. [ABSTRACT FROM AUTHOR]

Wilkie syndrome or superior mesenteric artery syndrome is a rare cause of duodenal obstruction in pediatric and adult age groups. Its manifestations are due to compression of the third portion of the duodenum between the aorta and the superior mesenteric artery. We present one case of a 29-year-old female with a recent history of epigastric pain and severe weight loss due to duodenal obstruction from superior mesenteric syndrome. She was treated conservatively with jejunostomy tube feeding to regain loss of weight. Our case is unique in that the patient has also nutcracker syndrome. [ABSTRACT FROM AUTHOR]

Introduction: Superior mesenteric artery (SMA) syndrome is a well-described condition involving mechanical compression of the third part of the duodenum by the SMA and the aorta, resulting in proximal obstruction.Discussion: Although there are a handful of case reports describing various techniques of laparoscopic duodenojejunostomy, a technique that involves creating the anastomosis in the infracolic compartment provides a more dependent stoma for the patient.Conclusion: This is a safe, effective, and relatively simple procedure for the experienced minimally invasive surgeon. [ABSTRACT FROM AUTHOR]