Niasse Abdou, Faye Papa Mamadou, Ndong Abdourahmane, Kuadjovi Serge Ramou, Leye Abdoulaye, Diack Ngoné Diaba, Gueye Mohamadou Lamine, Thiam Ousmane, Ndiaye Mamadou, Diouf Ahmed, Sarr Ibrahima Sitor Souleymane, Seye Yacine, Toure Alpha Oumar, Seck Mamadou, Cisse Mamadou, Dieng Madieng
Service de Chirurgie, Centre Hospitalier National de Pikine, Dakar, Sénégal.
Service de Chirurgie Générale, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal.
Pan Afr Med J. 2022 Jul 20;42:217. doi: 10.11604/pamj.2022.42.217.27281. eCollection 2022.
Superior mesenteric artery syndrome or Wilkie syndrome is due to the compression of the third duodenum between the superior mesenteric artery and the aorta. It causes acute or chronic upper bowel occlusion. Abdominal CT scan facilitates the diagnosis. Severe malnutrition is its main etiological factor. Medical treatment can be based on aspiration of gastric contents and parenteral nutrition. If this fails, surgery is necessary. We here report the case of a 46-year-old patient, with a history of smoking, presenting with profuse postprandial bile and food vomiting. He had had weight loss of 7% over a period of 6 months. Upper GI endoscopy revealed non-stenotic antro-pyloric tumour mass. Histological examination showed poorly differentiated tubular gastric adenocarcinoma. Staging was without any peculiarity and allowed for the detection of superior mesenteric artery syndrome at an angle of 8°C. The patient received parenteral nutrition for 10 days, followed by inferior pole gastrectomy and gastrojejunal anastomosis (omega loop). The postoperative course was uneventful. Adjuvant chemotherapy was indicated.
肠系膜上动脉综合征或威尔基综合征是由于肠系膜上动脉与主动脉之间对十二指肠第三部的压迫所致。它会引起急性或慢性上消化道梗阻。腹部CT扫描有助于诊断。严重营养不良是其主要病因。内科治疗可基于胃内容物抽吸和肠外营养。如果治疗失败，则需要手术。我们在此报告一例46岁有吸烟史的患者，出现大量餐后胆汁和食物呕吐。他在6个月内体重减轻了7%。上消化道内镜检查发现非狭窄性胃窦-幽门肿瘤块。组织学检查显示为低分化管状胃腺癌。分期无特殊情况，并在8°角处检测到肠系膜上动脉综合征。患者接受了10天的肠外营养，随后进行了胃下极切除术和胃空肠吻合术（ω袢）。术后过程顺利。需要进行辅助化疗。
