Al Faqeeh Ahmad A, Syed Muhammad Khalid, Ammar Mohammed, Almas Talal, Syed Saifullah
Pediatric Surgery, King Fahad Hospital, Al Baha, SAU.
Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL.
Cureus. 2020 Sep 15;12(9):e10467. doi: 10.7759/cureus.10467.
Superior mesenteric artery syndrome, or Wilkie's syndrome, is an unexpected cause of upper gastrointestinal tract obstruction. The exact incidence of the condition remains unknown, and limited case reports are present in the literature. The obstruction results in the compression of the third part of the duodenum between the superior mesenteric artery and aorta. It is widely known that a lack of subcutaneous tissue in the area can precipitate the obstruction by significantly reducing the aortomesenteric angle. Wilkie's syndrome presents a clinically diagnostic challenge as patients initially remain undiagnosed with relapsing episodes of upper abdominal pain and bilious vomiting. In some cases, an acute obstruction may arise. Undertaking an initial contrast study of the upper gastrointestinal tract and a CT scan are required to confirm the diagnosis of the condition. In the present study, we elucidate the case of a 12-year-old girl who presented with upper abdominal pain and bouts of bilious vomiting. Upon extensive diagnostic evaluation, Wilkie's syndrome was diagnosed. Since the patient failed to respond to conservative treatment, a laparotomy with subsequent duodenojejunostomy was undertaken. The postoperative recovery of the patient was uneventful with no recurrence of symptoms on follow-up.
肠系膜上动脉综合征，即威尔基综合征，是上消化道梗阻的一种罕见病因。该病的确切发病率尚不清楚，文献中仅有有限的病例报告。梗阻是由于十二指肠第三部被肠系膜上动脉和主动脉压迫所致。众所周知，该区域缺乏皮下组织会显著减小主动脉与肠系膜夹角，从而引发梗阻。威尔基综合征在临床上具有诊断挑战性，因为患者最初常因反复出现上腹部疼痛和胆汁性呕吐而未被诊断出来。在某些情况下，可能会出现急性梗阻。需要进行上消化道造影和CT扫描以确诊该病。在本研究中，我们阐述了一名12岁女孩的病例，她出现上腹部疼痛和多次胆汁性呕吐。经过全面的诊断评估，确诊为威尔基综合征。由于患者对保守治疗无反应，遂进行了剖腹手术并随后实施了十二指肠空肠吻合术。患者术后恢复顺利，随访期间症状未复发。
