Superior mesenteric artery syndrome is a potentially life-threatening condition that affects the gastrointestinal tract. It occurs when the duodenum, the part of the small intestine that connects to the stomach, is compressed by a large artery in the abdomen. The condition can be acute or chronic, and symptoms can potentially arise at any age. Most acute cases can be treated with medications, rest, and a feeding tube, but chronic problems often necessitate surgery to prevent serious complications.
The duodenum is situated between the superior mesenteric artery and the abdominal aorta. If the superior artery is angled steeply inward, it can put pressure on the duodenum and impair digestion. Superior mesenteric artery syndrome may be caused by a congenital defect of the stomach or artery, severe trauma to the abdomen, or prolonged periods of bed rest or immobilization. Occasionally, patients experience the condition after undergoing surgery on their stomachs or lower backs. Females and especially thin males between the ages of 10 and 30 are at the highest risk of developing the condition, but congenital defects can cause problems at a younger age.
Symptoms of this disorder may come about suddenly or progressively get worse over several months. The most common symptoms are stomach cramps, constant abdominal pain, nausea, and belching. A person may feel full after very small meals and vomit frequently. Symptoms tend to be the worst when lying on the back, and pains are usually relieved somewhat when lying on the stomach.
Complications can be deadly if the condition is not recognized and treated accurately. An individual may become malnourished or dehydrated due to difficulties eating and accompanying gastrointestinal problems. It is also possible for the duodenum or stomach to rupture under constant pressure. A person who experiences sudden or worsening stomach pains should visit a doctor as soon as possible.
It is possible for a physician to misdiagnose superior mesenteric artery syndrome upon an initial evaluation since it is a very rare disorder. By carefully reviewing the results of diagnostic imaging tests, a specialist can usually confirm that the artery is indeed angled and compressing the duodenum. Patients with acute superior mesenteric artery syndrome are typically hospitalized, placed on their sides, and given feeding tubes. Intravenous medications and fluids help to stimulate the gastrointestinal tract and prevent dehydration.
Chronic and congenital problems are usually treated with surgery. If a defect is minor, a surgeon may be able to manually realign the artery and duodenum. In most cases, however, a procedure called a duodenojejunostomy is needed to bypass the compressed section and connect a lower part of the intestine to the stomach. Surgical repair has a high success rate, and most patients are able to fully recover within about six months.