The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Superior Mesenteric Artery Syndrome: Past and Present

상장간막동맥증후군: 과거와 현재

  • Kim, Eui Bae (Institution for Digestive Research, Department of Internal Medicine, Soonchunhyang University Hospital) ;
  • Lee, Tae Hee (Institution for Digestive Research, Department of Internal Medicine, Soonchunhyang University Hospital)
  • 김의배 (순천향대학교 의과대학 내과학교실) ;
  • 이태희 (순천향대학교 의과대학 내과학교실)
  • Published : 2013.01.01
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Abstract

Superior mesenteric artery syndrome (SMAS) is an uncommon disease resulting from compression of the third portion of the duodenum by the superior mesenteric artery. Typical symptoms of SMAS are anorexia, nausea, vomiting, early satiety, abdominal pain and postprandial fullness. The diagnosis requires radiologic studies in patients with symptoms suggestive of SMAS. Radiologic studies include upper gastrointestinal barium study, angiography, abdominal ultrasound, endoscopic ultrasound, computed tomography (CT), and magnetic resonance imaging. The SMA angle to the aorta is normally $45^{\circ}$ (range, $38-56^{\circ}$), whereas in SMAS, that SMA angle is decreased to 6 to $25^{\circ}$. Additionally, the distance between the SMA and the aorta normally ranges from 10 to 20 mm, whereas in SMAS this distance is decreased to 2 to 8 mm. Recently SMAS diagnosis has been most commonly confirmed by CT. Therapy of SMAS includes weight gain to increase the aortomesenteric angle, but surgery is indicated in symptomatic patients when conservative management failed. To date, laparoscopic duodenojejunostomy seems to be a first-choice surgical options.

Keywords

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