Superior Mesenteric Artery Syndrome
What is Superior Mesenteric Artery Syndrome?
Superior Mesenteric Artery Syndrome occurs when the 3rd portion of the duodenum becomes compressed between the Superior Mesenteric Artery and the Abdominal Aorta. This compression causes partial to complete duodenal obstruction.
Superior Mesenteric Artery Syndrome occurs when the 3rd portion of the duodenum becomes compressed between the Superior Mesenteric Artery and the Abdominal Aorta. This compression causes partial to complete duodenal obstruction.
GARD states: “Researchers have made several estimates of the prevalence rate of SMA syndrome in the population. These estimates have ranged from 0.013% to 0.3% in the general population, which translates roughly to 41,000 to 96,000 Americans with SMA syndrome.[1][2][3] Most of the prevalence rate estimates quoted in recent published articles can be traced back to studies done between 1956-1966.[4][5] Recent studies to determine the prevalence rate of SMA syndrome do not seem to be available, making it difficult at present to give a more accurate estimate.
”References:
1. Welsch T, Buchler MW, Kienle P. Recalling superior mesenteric artery syndrome. Dig Surg. 2007; http://www.karger.com/Article/FullText/102097.
2. Karrer FM, Jones SA: Superior mesenteric artery syndrome. Medscape Research. July 2015; http://emedicine.medscape.com/article/932220-overview
3. Zaraket V, Deeb L: Wilkie’s syndrome or superior mesenteric artery syndrome: fact or fantasy? Case Rep Gastroen 2015; 9: 194-199. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478323/
4. Goin LS, Wilk SP. Intermittent ateriomesenteric occulusion of the duodenum. Radiology. 1956; 67: 729-737.
5. Nugent FW, Braasch JW, Epstein H: Diagnosis and surgical treatment of arteriomesenteric obstruction of the duodenum. JAMA. 1966; 196: 1091-1093
SMAS occurs when the mesenteric and retroperitoneal fat surrounding and supporting the SMA/aorta becomes diminished. The normal angle at the SMA/aorta is 20-56, normal distance of SMA/aorta is 10-20mm. In SMA Syndrome the angle will be less than 20 degrees, while the distance is 2-8mm. SMAS can be either chronic or acute.
Chronic SMAS is felt to be congenital, from birth, and can be intermittant, or present as a lifelong history of abdominal issues, usually of unknown etiology. There are many cause of chronic SMAS: a lean, aesthenic body type, high insertion of the ligament of treitz or a shortened LOT, low insertion of the SMA artery on the aorta, or malrotation of the intestines.
Acute SMAS occurs rapidly after any sudden weight loss or traumatic accident that causes loss of mesenteric fat. Examples include burns, scoliosis surgery, prolonged bed rest, abdominal trauma, and car accidents.
While weight loss is a symptom of SMAS, and SMAS mimics eating disorders, it is important to determine if someone truly has SMAS, as misdiagnosis can be fatal.
Weight Loss, Nausea, Vomiting, Early Satiety (feeling full very quickly), Pain after eating, Abdominal Distention, Belching, Left Upper Abdominal Pain (Midline), Heartburn, Reflux
CTA has been considered the Gold standard for diagnosis, while UGI with small bowel follow through, MRI/MRA, and US are also used to diagnose. Gastric Emptying test may be used to exclude gastroparesis. SMA Syndrome diagnosis is often a diagnosis of exclusion.
A recent research study in Korea showed a minimum 6 week course of medical management was effective for children. If this should fail, then they recommend surgery.
The surgery of choice for SMAS at this time is duodenojejunostomy.
Other surgical options include- duodenal derotation, lysis of the ligament of treitz, gastrojejunostomy, SMA Transposition.
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| Title | Description | Date | Link |
|---|---|---|---|
| Superior Mesenteric Artery Syndrome Research Awareness and Support | The only SMAS Nonprofit in the US. OUR MISSION “Promoting health care opportunities for under-insured individuals, promoting research for improved health care for all members with superior mesenteric artery syndrome, and is dedicated to educating both the medical community and the public about superior mesenteric artery syndrome symptoms to encourage early diagnosis.” | 04/27/2018 |
Clinical Trials
CoRDS, or the Coordination of Rare Diseases at Sanford, is based at Sanford Research in Sioux Falls, South Dakota. It provides researchers with a centralized, international patient registry for all rare diseases. This program allows patients and researchers to connect as easily as possible to help advance treatments and cures for rare diseases. The CoRDS team works with patient advocacy groups, individuals and researchers to help in the advancement of research in over 7,000 rare diseases. The registry is free for patients to enroll and researchers to access.
Enrolling is easy.
- Complete the screening form.
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- Answer the permission and data sharing questions.
After these steps, the enrollment process is complete. All other questions are voluntary. However, these questions are important to patients and their families to create awareness as well as to researchers to study rare diseases. This is why we ask our participants to update their information annually or anytime changes to their information occur.
Researchers can contact CoRDS to determine if the registry contains participants with the rare disease they are researching. If the researcher determines there is a sufficient number of participants or data on the rare disease of interest within the registry, the researcher can apply for access. Upon approval from the CoRDS Scientific Advisory Board, CoRDS staff will reach out to participants on behalf of the researcher. It is then up to the participant to determine if they would like to join the study.
Visit sanfordresearch.org/CoRDS to enroll.
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SMA Syndrome
In 2012 I was diagnosed with SMAS. I had duodenojejunostomy at Johns Hopkins Dec 2012. I continue to struggle with digestive issues, and have also been diagnosed with Nutcracker Syndrome, Pelvic Congestion Syndrome, and May Thurner Syndrome. In 2016 I had SMA Transposition surgery to correct my Nutcracker Syndrome and to relieve to compression on my duodenum. My daughter and I started and run the only Nonprofit dedicated to assisting those with Superior Mesenteric Artery Syndrome in the USA. smasyndrome.org
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In 2012 I was diagnosed with SMAS. I had duodenojejunostomy at Johns Hopkins Dec 2012. I continue to struggle with digestive issues, and have also been diagnosed with Nutcracker Syndrome, Pelvic...
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