Madhab Gayatri, Madsen Jette, Brems Dalgaard Eva, Bharadwaz Arindam
Department of Radiology, Viborg Regional Hospital, Viborg, Denmark.
Department of Radiology, Aarhus University Hospital, Aarhus, Denmark.
Euroasian J Hepatogastroenterol. 2014 Jan-Jun;4(1):58-60. doi: 10.5005/jp-journals-10018-1098. Epub 2014 Jan 22.
Rare causes of common symptoms often pose a diagnostic dilemma which can lead to unwanted loss of precious time in proper diagnosis and management. Superior mesenteric artery (SMA) syndrome is such a rare disorder. It typically presents with signs and symptoms of upper gastrointestinal (GI) obstruction which can be mimicked by a variety of clinical conditions, such as peptic ulcer, chronic pancreatitis, mesenteric ischemia and systemic lupus erythematosus (SLE). A high degree of clinical suspicion is required to direct proper investigations to narrow down to the correct diagnosis. Multi-detector CT (MDCT) proves to be invaluable not only in ruling out more common conditions mimicking SMA syndrome but also in arriving at the correct diagnosis quickly and effectively with great clinical accuracy and thereby removing confusion and delay in proper management.
SMA: Superior mesenteric artery; GI: Gastrointestinal; MDCT: Multidetector computed tomography; MPR: Multiplanar reconstruction; AMA: Aortomesenteric Angle; AMD: Aortomesenteric distance. Madhab G, Madsen J, Dalgaard EB, Bharadwaz A. Superior Mesenteric Artery Syndrome: A Rare Mimic of Common Causes of Upper Gastrointestinal Obstruction. Euroasian J Hepato-Gastroenterol 2014;4(1):58-60.
常见症状的罕见病因常常会造成诊断上的两难局面,这可能导致在正确诊断和治疗过程中宝贵时间的不必要浪费。肠系膜上动脉(SMA)综合征就是这样一种罕见疾病。它通常表现为上消化道(GI)梗阻的症状和体征,而这些症状可能被多种临床情况所模仿,如消化性溃疡、慢性胰腺炎、肠系膜缺血和系统性红斑狼疮(SLE)。需要高度的临床怀疑来指导进行适当的检查,以缩小范围得出正确诊断。多排螺旋CT(MDCT)不仅在排除模仿SMA综合征的更常见情况方面具有重要价值,而且在以很高的临床准确性快速有效地做出正确诊断方面也很有价值,从而消除正确治疗中的困惑和延误。
SMA:肠系膜上动脉;GI:胃肠道;MDCT:多排螺旋计算机断层扫描;MPR:多平面重建;AMA:主动脉肠系膜角;AMD:主动脉肠系膜距离。Madhab G、Madsen J、Dalgaard EB、Bharadwaz A。肠系膜上动脉综合征:上消化道梗阻常见病因的罕见模仿者。《欧亚肝脏胃肠病学杂志》2014年;4(1):58 - 60。