Fernández López Ma T, López Otero Ma J, Bardasco Alonso Ma L, Álvarez Vázquez P, Rivero Luis Ma T, García Barros G
Servicio de Endocrinología y Nutrición, Complexo Hospitalario Ourensano, Ourense, España.
Nutr Hosp. 2011 May-Jun;26(3):646-9. doi: 10.1590/S0212-16112011000300031.
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%.
威尔基综合征是一种罕见的高位胃肠道梗阻形式,由腹主动脉和肠系膜上动脉(SMA)对十二指肠的压迫所致。导致该综合征的情况可分为五类:严重消耗性疾病、严重损伤、脊柱疾病、畸形或创伤、饮食紊乱及术后状态。症状包括恶心、呕吐、餐后腹胀、上腹部疼痛和体重减轻。钡餐和动脉造影曾用作诊断工具,现在CT血管造影正在被使用且显示出更高的诊断敏感性。诊断标准为:十二指肠扩张、SMA对十二指肠的压迫以及腹主动脉肠系膜夹角<20度。急性综合征患者常对保守治疗(减压、纠正脱水和电解质失衡以及营养支持)有反应。大多数慢性综合征患者需要手术干预。十二指肠空肠吻合术是最有效的手术选择,成功率为90%。