Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Superior mesenteric artery syndrome can lead to duodenal obstruction due to vascular compression. We treated a patient with superior mesenteric artery syndrome by performing a complete laparoscopic duodenojejunostomy with a linear stapled closure of the common enterotomy. A 72-year-old woman presented with nausea, vomiting, and weight loss. CT revealed superior mesenteric artery syndrome. Conservative management was not effective. Because the patient required a surgical bypass for long-term relief, a laparoscopic duodenojejunostomy was performed. In past cases, hand-sewn sutures were made through a small incision to avoid stenosis when the common enterotomy was closed. For our patient, we closed the common enterotomy with a linear stapler in a complete laparoscopic maneuver. We performed the closure after placing several temporary sutures to minimize the amount of intestinal wall to be removed. Laparoscopic duodenojejunostomy is a minimally invasive procedure, and a linear stapled closure of a common enterotomy is a safe surgical technique that reduces invasiveness.
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PMID:Complete laparoscopic duodenojejunostomy for superior mesenteric artery syndrome: Linear stapled closure of the common enterotomy. 3184 94

BACKGROUND Superior mesenteric artery syndrome is the compression of the third portion of the duodenum between the superior mesenteric artery and the aorta causing abdominal pain and vomiting. Nutcracker syndrome is the compression of the left renal vein between the superior mesenteric artery and the aorta causing symptoms related to renal congestion. Both entities, although well described in the literature, are individually rare, and even though they might share a common etiology, their co-existence has been reported in only a few case reports. CASE REPORT An 18-year-old male, previously healthy, presented with postprandial abdominal pain relieved by bilious vomiting that started shortly after he lost weight fasting. Our investigation revealed superior mesenteric artery syndrome as well as a compressed left renal vein. He was started on an enriched fluid diet which was progressed gradually as he regained weight. His left renal vein compression at the time was asymptomatic; it will be followed up for possible resolution after the patient's weight returns to normal. CONCLUSIONS Superior mesenteric artery syndrome is to be suspected in patients with abdominal pain following weight loss. Conservative treatment with a focus on weight regain will cure most cases. Asymptomatic or mildly symptomatic nutcracker syndrome is treated conservatively. For patients requiring intervention, laparoscopic extravascular titanium stent placement seems to be the least invasive promising option today, awaiting further definitive studies.
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PMID:Combined Superior Mesenteric Artery Syndrome and Nutcracker Syndrome in a Young Patient: A Case Report and Review of the Literature. 3277 39

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.
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PMID:Wilkie's Syndrome as a Rare Cause of Duodenal Obstruction: Perspicacity Is in the Radiological Details. 3308 70


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