SMA syndrome

SMA or superior mesenteric artery syndrome is an extremely unusual and life-threatening disorder of the gastro-vascular system. It is characterized by compression of the third part of the duodenum. In 1861, it was first described by Carl Freiherr von Rokitansky while performing an autopsy of the victims. SMA syndrome is also referred to as intermittent arterio-mesenteric occlusion, mesenteric root syndrome, Wilkie’s syndrome, chronic duodenal ileus and cast syndrome.

The symptoms are severe malnutrition accompanied with spontaneous wasting, nausea, abdominal distention or distortion, early satiety, eructation, extreme “stabbing” postprandial pain in the abdomen because of compensatory reversed peristalsis and duodenal compression and external hypersensitivity or tenderness of the abdominal area. In turn, the duodenal compression is increased provoking a vicious cycle. Patients with the chronic form of SMA syndrome will commonly develop “food fear”. The symptoms are partly relieved when a person is in a left lateral decubitus or knee-to-chest position. A Hayes maneuver which is the application of pressure below the umbilicus both in cephalad and dorsal directions can elevate the root of SMA which will also ease the constriction to some extent. The symptoms are frequently aggravated when a person leans to the right or takes a supine or face up position.

It is believed that only four hundred cases in medical literature history have been reported since a lot of people consider it to be a rumor and nothing else. Yet, extensive research is still going on. Doctors have documented evidence showing that even if superior mesenteric artery syndrome is extremely rare, this really exists.

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