Hutchinson D T, Bassett G S
Alfred I, duPont Institute, Wilmington, DE 19899.
Clin Orthop Relat Res. 1990 Jan(250):250-7.
Superior mesenteric artery (SMA) syndrome is a rare cause of small bowel obstruction in both adult and pediatric populations. Of 14 patients with the diagnosis from 1979 to 1987, eight had confirmatory upper gastrointestinal studies and were able to be followed for an average of 32 months. All eight were of similar age (range, 14.2 to 19 years), body build (asthenic), and clinical presentation. The presentation included nausea and intermittent, voluminous, bile-stained vomiting, despite intervening periods of normal appetite and bowel sounds. The average delay in diagnosis was five days. Nasogastric drainage and intravenous fluids were the mainstay of treatment and were successful in every case. Fifty percent of the patients had more than one episode requiring treatment; each episode resolved with simple treatment. Two of three patients with body casts required cast removal. No patient required intravenous hyperalimentation, removal of spinal instrumentation, or abdominal surgery to relieve the obstruction. Three of the eight patients had not had spinal surgery or cast immobilization.
肠系膜上动脉（SMA）综合征是成人和儿童小肠梗阻的罕见病因。在1979年至1987年确诊的14例患者中，8例进行了确诊性上消化道检查，并得以平均随访32个月。所有8例患者年龄相仿（14.2至19岁），体型（无力型）和临床表现相似。临床表现包括恶心以及间歇性、大量、胆汁样呕吐，尽管其间食欲和肠鸣音正常。平均诊断延迟为5天。鼻胃管引流和静脉补液是主要治疗方法，且每例均成功。50%的患者有不止一次发作需要治疗；每次发作经简单治疗后均缓解。使用身体石膏固定的3例患者中有2例需要拆除石膏。没有患者需要静脉高营养、拆除脊柱内固定器械或进行腹部手术来解除梗阻。8例患者中有3例未进行过脊柱手术或石膏固定。
