Sánchez-Lozada Raúl, Acosta-Rosero Ana Vanessa, Balas-Salame Carlos, Chapa-Azuela Oscar, Hurtado-López Luis Mauricio
Servicio de Cirugía, Hospital General de México.
Rev Gastroenterol Mex. 2002 Jan-Mar;67(1):38-42.
Superior mesenteric artery syndrome (SMAS) is the obstruction of the duodenum in the third portion due to this artery. We present a case of chronic oral feeding intolerance due to this problem.
A 24 year-old woman, with a time of evolution of 1 year and a half of postprandial epigastric pain with nausea, vomiting, and loss of 30 kg managed as acid-peptic disease. The patient was studied with gastrointestinal contrast study and endoscopy without conclusive results. The patient was admitted for unstoppable vomiting, malnutrition, and severe dehydration. A laparotomy was performed and SMAS was identified. We performed Treitz's ligament section and gastrojejunoanastomosis. Her clinical outcome was satisfactory and the patient was discharged without complications.
SMAS is also called Wilkie's syndrome. SMAS is more frequent in women between the 10 and 39 years. The disease due to the decrease of the angle between the superior mesenteric artery and the aorta, to the anomalous origin of this artery, or to the shortening of Treitz's ligament. SMAS may appear as a sudden weight loss. Food intolerance is a predominant symptom. Diagnosis can be made with x-ray studies. Treatment is medical or surgical, with Treitz's ligament section, duodenojejunoanastomosis, and in some cases gastrojejunoanastomosis.
SMAS should be considered as no the differential diagnosis of chronic oral feeding intolerance.
肠系膜上动脉综合征（SMAS）是由于该动脉导致十二指肠第三部分梗阻。我们报告一例因该问题导致慢性经口喂养不耐受的病例。
一名24岁女性，病程1年半，餐后上腹部疼痛伴恶心、呕吐，体重减轻30公斤，最初按酸相关性疾病治疗。对该患者进行了胃肠道造影检查和内镜检查，但结果不明确。患者因持续性呕吐、营养不良和严重脱水入院。行剖腹探查术，确诊为肠系膜上动脉综合征。我们进行了Treitz韧带切断术和胃空肠吻合术。她的临床结局令人满意，患者出院时无并发症。
肠系膜上动脉综合征也称为威尔基综合征。该综合征在10至39岁女性中更为常见。病因是肠系膜上动脉与主动脉之间夹角减小、该动脉起源异常或Treitz韧带缩短。肠系膜上动脉综合征可能表现为体重突然减轻。食物不耐受是主要症状。可通过X线检查进行诊断。治疗方法有药物治疗或手术治疗，包括Treitz韧带切断术、十二指肠空肠吻合术，某些情况下还可行胃空肠吻合术。
肠系膜上动脉综合征应被视为慢性经口喂养不耐受鉴别诊断的考虑因素之一。
