Wilkie's syndrome, or superior mesenteric artery syndrome (SMAS), is a rare clinical entity caused by compression of the third portion of the duodenum between the abdominal aorta and superior mesenteric artery, leading to duodenal obstruction and severe malnutrition. The authors report a case of a female patient with years of chronic intestinal obstruction with abdominal pain, vomits and weight loss. Contrast intestinal series showed dilation of stomach and duodenum. Abdominal computed tomography study revealed findings compatible with SMAS. After initial nutritional support, she was successfully treated by laparoscopic duodenojejunostomy. Surgical treatment of SMAS may be necessary in most cases with chronic symptoms or conservative treatment failure. A minimally invasive approach can be considered a safe surgical option with favourable outcomes. Clinical details, diagnostic studies and treatment are discussed.
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http://dx.doi.org/10.1093/jscr/rjy027 | DOI Listing |
Int J Surg Case Rep
January 2025
Faculty of Medicine, Department of Internal Medicine, Division of Gastroenterology, University of Aleppo, Aleppo, Syria.
Introduction: Superior mesenteric artery (SMA) syndrome is a rare condition with a significant decrease in the angle between the SMA and the abdominal aorta.
Presentation Of Case: A 16-year-old girl presented with abdominal pain, vomiting, weight loss, and loss of appetite. Family history included allergies to contrast media.
Am J Case Rep
October 2024
Division for General, Visceral and Transplantation Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
BACKGROUND Superior mesenteric artery syndrome, also known as Wilkie's syndrome, is a rare etiology of obstruction of the lower duodenum between the superior mesenteric artery and aorta. It often presents with unspecific abdominal pain and laboratory findings, resulting in difficult diagnosis and treatment. CASE REPORT A 21-year-old male patient was admitted to our clinic with a 13-month history of coughing, ill feeling, night sweats, vomiting, unintentional weight loss, and epigastric pain.
View Article and Find Full Text PDFCureus
August 2024
Department of Surgery, Texas Tech University Health Sciences Center, Amarillo, USA.
Superior mesenteric artery (SMA) syndrome, also known as Wilkie's syndrome, is a rare condition resulting from compression of the third portion of the duodenum between the aorta and the superior mesenteric artery. When symptomatic, this compression may result in nausea, vomiting, epigastric discomfort, and weight loss, requiring clinical attention and imaging to make the diagnosis. Typically, SMA syndrome presents in young females and is associated with an underlying condition such as anorexia nervosa, cachexia, postoperative development after scoliosis surgery, etc.
View Article and Find Full Text PDFRadiol Case Rep
November 2024
General Surgery, Centro Medico Nacional de Occidente, Guadalajara, Mexico.
Superior mesenteric artery syndrome, or Wilkie's syndrome, is one of the rarest gastrointestinal disorders known to medical science. It is characterized by the vascular clamp of the third portion of the duodenum, between the superior mesenteric artery and the aorta. It presents as an uncommon cause of upper intestinal obstruction.
View Article and Find Full Text PDFDiagnostics (Basel)
August 2024
Department of Experimental and Clinical Medicine, University "Magna Græcia", Viale Europa, 88100 Catanzaro, Italy.
Superior mesenteric artery (SMA) syndrome or Wilkie's syndrome is a vascular compression disorder that causes the abnormal compression of the third portion of the duodenum by the SMA. It has a low incidence rate, which is higher in young women, and is rarely associated with the Nutcracker phenomenon: a condition of the compression of the left renal vein between the SMA and the aorta, which manifests as pain in the left flank and pelvis. Here, we report on the case of a 54-year-old woman with a history of repeated episodes of abdominal pain caused by the Nutcracker syndrome and Wilkie's syndrome.
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