Superior mezenterik arter sendromlu hastada superior mezenterik arter trombozu birlikteliği: Olgu sunumu

Yıl 2019, , 330 - 332, 28.04.2019

Erdi Seçkin

https://doi.org/10.28982/josam.510947

Öz

Superior mezenterik arter (SMA) sendromu; bulantı, kusma ve epigastrik ağrı gibi semptomları olan nadir bir sendromdur. SMA sendromu ayrıca Wilkie sendromu, mezenterik kök sendromu, kronik duodenal ileus sendromu olarak da bilinir. SMA sendromu, duodenumun üçüncü bölümünün SMA ile aort arasındaki vasküler kompresyonudur. Bu yazıda, acil servise abdominal ağrı ve bilgisayarlı tomografi ile gösterilen superior mezenterik arterinin ilişkili trombozuyla başvuran SMA sendromlu yetişkin bir hastayı sunacağız. SMA sendromu nadir olduğundan ve semptomların sık görülmediğinden, bazı tanısal zorluklar ortaya çıkabilir ve bu hasta için gereksiz uzun süreli semptomatik tedavilere yol açacaktır. Bu hastalarda, karın ağrısının ayırıcı tanısında mezenterik arter trombozu düşünülmelidir.

Anahtar Kelimeler

Superior mezenterik arter sendromu, Superior mezenterik arter trombozu, Akut abdomen, Wilkie sendromu

Superior mesenteric artery syndrome with superior mesenteric artery thrombosis: A case report

Öz

Superior mesenteric artery (SMA) syndrome is a rare syndrome with symptoms including nausea, vomiting and epigastric pain. SMA syndrome is also known as Wilkie’s syndrome, mesenteric root syndrome, chronic duodenal ileus syndrome. SMA syndrome is vascular compression of the third part of the duodenum between the SMA and the aorta. In this article, we will present an adult patient with SMA syndrome who was admitted to the emergency service with abdominal pain and associated thrombosis of her superior mesenteric artery, demonstrated by computed tomography. Since SMA syndrome is rare and symptoms are not frequent, some diagnostic difficulties might happen and this will lead unnecessary long-term symptomatic treatments for the patient. In such patients, mesenteric artery thrombosis should be considered in differential diagnosis of abdominal pain.

Anahtar Kelimeler

Acute abdomen, Superior mesenteric artery syndrome, Superior mesenteric artery thrombosis, Wilkie's syndrome

Kaynakça

• 1. Gustafsson L, Falk A, Lukes PJ, Gamklou R. Diagnosis and treatment of superior mesenteric artery syndrome. Br J Surg. 1984 Jul;71(7):499-501.
• 2. Arthurs OJ, Mehta U, Set PA. Nutcracker and SMA syndromes: What is the normal SMA angle in children? Eur J Radiol. 2012 Aug;81(8):e854-61. doi: 10.1016/j.ejrad.2012.04.010
• 3. Welsch T, Büchler MW, Kienle P. Recalling superior mesenteric artery syndrome. Dig Surg. 2007;24(3):149-56.
• 4. Goin LS, Wilk SP. Intermittent arteriomesenteric occlusion of the duodenum. Radiology. 1956 Nov;67(5):729-37.
• 5. Lee TH, Lee JS, Jo Y, Park KS, Cheon JH, Kim YS, et al. Superior mesenteric artery syndrome: where do we stand today? J Gastrointest Surg. 2012 Dec;16(12):2203-11. doi: 10.1007/s11605-012-2049-5.
• 6. Shetty AK, Schmidt-Sommerfeld E, Haymon ML, Udall JN Jr. Radiological case of the month. Superior mesenteric artery syndrome. Arch Pediatr Adolesc Med. 1999 Mar;153(3):303-4.
• 7. Merrett ND, Wilson RB, Cosman P, Biankin AV. Superior mesenteric artery syndrome: diagnosis and treatment strategies. J Gastrointest Surg. 2009 Feb;13(2):287-92. doi: 10.1007/s11605-008-0695-4.
• 8. Shin MS, Kim JY. Optimal duration of medical treatment in superior mesenteric artery syndrome in children. J Korean Med Sci. 2013 Aug;28(8):1220-5. doi: 10.3346/jkms.2013.28.8.1220.
• 9. Richardson WS, Surowiec WJ. Laparoscopic repair of superior mesenteric artery syndrome. Am J Surg. 2001 Apr;181(4):377-8.
• 10. Baltazar U, Dunn J, Floresguerra C, Schmidt L, Browder W. Superior mesenteric artery syndrome: an uncommon cause of intestinal obstruction. South Med J. 2000 Jun;93(6):606-8.