Lee C S, Mangla J C
Am J Gastroenterol. 1978 Aug;70(2):141-50.
An attempt was made to search the medical records of the University Hospital and five affiliated hospitals at Rochester, NY for the last 10 years. Seventeen patients with superior mesenteric artery compression syndrome were found. The prevalence of this disease in a chronic-care hospital (0.965/1,000 admisssions) is significantly higher than that in acute general hospitals (0.0108-0.0520/1,000 admissions) by Chi square statistic (P less than 0.001). This syndrome should be suspected in patients with chronic wasting diseases who are bedridden and have lost weight after which they develop frequent vomiting or aspirations. On reviewing 146 cases from the literature after 1963, duodenojejunostomy was considered to be the best procedure for severe cases. The same good results were not achieved after gastrojejunostomy and lysis of the ligament of Treitz. Gastrojejunostomy provided adequate decompression of the stomach but was inadequate for releasing duodenal obstruction. Some patients after division of the ligament of Treitz had difficulty in downward displacement of the duodenum and the symptoms of obstruction persisted necessitating duodenojejunostomy. This paper demonstrates that in two patients gastrojejunostomy failed to relieve the obstruction. One of them had to be reoperated on and a duodenojejunostomy was performed with relief of obstructive symptoms.
我们尝试检索纽约州罗切斯特市大学医院及其五家附属医院过去10年的病历。共发现17例肠系膜上动脉压迫综合征患者。通过卡方检验，该疾病在慢性病医院的患病率（0.965/1000例入院患者）显著高于急性综合医院（0.0108 - 0.0520/1000例入院患者）（P < 0.001）。对于患有慢性消耗性疾病、卧床且体重减轻后出现频繁呕吐或误吸的患者，应怀疑患有此综合征。回顾1963年后文献中的146例病例，十二指肠空肠吻合术被认为是重症病例的最佳手术方式。胃空肠吻合术和Treitz韧带松解术后未取得同样良好的效果。胃空肠吻合术可使胃得到充分减压，但不足以解除十二指肠梗阻。部分患者在Treitz韧带离断后，十二指肠向下移位困难，梗阻症状持续存在，仍需行十二指肠空肠吻合术。本文表明，有两名患者行胃空肠吻合术未能解除梗阻。其中一名患者不得不再次手术，行十二指肠空肠吻合术，梗阻症状得以缓解。
