Tsuji T
Department of Orthopaedic Surgery, Juntendo University, School of Medicine, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1987 Oct;61(10):1047-57.
Superior mesenteric artery (SMA) syndrome is a major complication after scoliosis surgery. The author reports an ultrasonic observation of the SMA in normal and scoliotic individuals. There are three patterns of the SMA anatomy: Type I in which the SMA runs very close and parallel to the aorta, Type II in which the SMA branches off the aorta at a certain angle and Type III in which the SMA runs parallel to the aorta. Dynamic observation revealed that passage of food displaces the SMA anteriorly and to the left and that turning to the left from a supine position displaces the SMA from just anterior to the left of the aorta in normal individuals and from the right to the left side of the aorta in scoliosis cases. AMA itself has no significance in the occurrence of SMA syndrome because the SMA moves rather freely with the passage of food or position change. When this natural movement of the SMA is disturbed, one should carefully look for the possibility of SMA syndrome.
肠系膜上动脉(SMA)综合征是脊柱侧弯手术后的一种主要并发症。作者报告了对正常人和脊柱侧弯患者的肠系膜上动脉的超声观察。肠系膜上动脉解剖结构有三种类型:I型,肠系膜上动脉与主动脉非常靠近且平行;II型,肠系膜上动脉以一定角度从主动脉分支;III型,肠系膜上动脉与主动脉平行。动态观察发现,食物通过时会使肠系膜上动脉向前和向左移位,正常个体从仰卧位向左转身时,会使肠系膜上动脉从主动脉前方偏左处移位,而脊柱侧弯患者则会使其从主动脉右侧移至左侧。肠系膜上动脉夹角本身对肠系膜上动脉综合征的发生并无意义,因为随着食物通过或体位改变,肠系膜上动脉移动较为自由。当肠系膜上动脉的这种自然移动受到干扰时,应仔细排查肠系膜上动脉综合征的可能性。