All are true regarding superior Mesenteric Aery Syndrome, except -
Ans. is 'd' i.e., Most common in 6th to 7th decade Superior Mesenteric Aery syndrome or Wilkie's syndrome - is a rare condition in which obstruction of the 3rd poion of duodenum is produced by compression between the superior mesenteric vessels and the aoa. Causes and pathophysiology - the superior mesenteric aery normally leaves the aoa at an acute angle (-50-60deg). Normally a mass of fat and lymphatics around the origin of SMA is believed to protect the duodenum from compression. Factors that may precipitate obstruction are sudden wt. loss following injury or bum rapid growth in height. - application of body casts - supine immobilization Clinical picture - the syndrome is seen invariably in thin patients - common in young adults, more common in females Symptoms include epigastric bloating and crampy pain after meals, relieved by vomitting or prone position. Investigation - Barium meal study Hypotonic duodenography is superior to barium meal - CT scan with contrast Management Conservative t/t - conservative t/t is successful in most cases associated with ohopedic condition. Treatment usually involves removal of plaster cast and mobilization of patient. - Postural therapy : patient is advised to turn into prone or knee-elbow position after meals or when symptomatic. Surgery - for patients not responding to conservative methods - duodenojejunostomy is done
Caused by compression of distended duodenum
Common in young females
Does not occur in obese individuals
Most common in 6th -7th decade