SUPERIOR MESENTERIC ARTERY SYNDROME: CLINICAL, ENDOSCOPIC AND RADIOLOGICAL FINDINGS

Raimondo, D.; Albano, D.

Risultato della ricerca: Article

1 Citazione (Scopus)

Abstract

Background. e superior mesenteric artery (SMA) syndrome is a rare entity presenting with upper gastrointestinal tract obstruction and weight loss. Studies to determine the optimal methods of diagnosis and treatment are required. Aims and Methods. is study aims at analyzing the clinical presentation, diagnosis, and management of SMA syndrome. Ten cases of SMA syndrome out of 2074 esophagogastroduodenoscopies were suspected. A contrast-enhanced computed tomography (CECT) scan was performed to conrm the diagnosis. Aer, a gastroenterologist and a nutritionist personalized the therapy. Furthermore, we compared the demographical, clinical, endoscopic, and radiological parameters of these cases with a control group consisting of 10 cases out of 2380 EGDS of initially suspected (but not radiologically conrmed) SMA over a follow-up 2-year period (2015-2016). Results. e prevalence of SMA syndrome was 0.005%. Median age and body mass index were 23.5 years and 21.5 kg/m , respectively. Symptoms developed between 6 and 24 months. Median aortomesenteric angle and aorta-SMA distance were 22 and 6 mm, respectively. All patients improved on conservative treatment. In our series, a marked (>5 kg) weight loss ( ) and a long-standing presentation (more than six months in 80% of patients) ( ) are signicantly related to a diagnosis of conrmed SMA syndrome at CECT aer an endoscopic suspicion. A “resembling postprandial distress syndrome dyspepsia” presentation may be helpful to the endoscopist in suspecting a latent SMA syndrome ( ). e narrowing of both the aortomesenteric angle ( ) and the aortomesenteric distance ( ) was signicantly associated with the diagnosis of SMA aer an endoscopic suspicion; however, the narrowing of the aortomesenteric distance seemed to be more accurate, rather than the narrowing of the aortomesenteric angle. Conclusion. SMA syndrome represents a diagnostic and therapeutic challenge. Our results show the following ndings: the importance of the endoscopic suspicion of SMA syndrome; the preponderance of a long-standing and chronic onset; a female preponderance; the importance of the nutritional counseling for the treatment; no need of surgical intervention; and better diagnostic accuracy of the narrowing of the aorta-SMA distance. Larger prospective studies are needed to clarify the best diagnosis and management of the SMA syndrome.
Lingua originaleEnglish
pagine (da-a)-
Numero di pagine7
RivistaGastroenterology Research and Practice
Volume2018
Stato di pubblicazionePublished - 2018

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SUPERIOR MESENTERIC ARTERY SYNDROME: CLINICAL, ENDOSCOPIC AND RADIOLOGICAL FINDINGS. / Raimondo, D.; Albano, D.

In: Gastroenterology Research and Practice, Vol. 2018, 2018, pag. -.

Risultato della ricerca: Article

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title = "SUPERIOR MESENTERIC ARTERY SYNDROME: CLINICAL, ENDOSCOPIC AND RADIOLOGICAL FINDINGS",
abstract = "Background. e superior mesenteric artery (SMA) syndrome is a rare entity presenting with upper gastrointestinal tract obstruction and weight loss. Studies to determine the optimal methods of diagnosis and treatment are required. Aims and Methods. is study aims at analyzing the clinical presentation, diagnosis, and management of SMA syndrome. Ten cases of SMA syndrome out of 2074 esophagogastroduodenoscopies were suspected. A contrast-enhanced computed tomography (CECT) scan was performed to conrm the diagnosis. Aer, a gastroenterologist and a nutritionist personalized the therapy. Furthermore, we compared the demographical, clinical, endoscopic, and radiological parameters of these cases with a control group consisting of 10 cases out of 2380 EGDS of initially suspected (but not radiologically conrmed) SMA over a follow-up 2-year period (2015-2016). Results. e prevalence of SMA syndrome was 0.005{\%}. Median age and body mass index were 23.5 years and 21.5 kg/m , respectively. Symptoms developed between 6 and 24 months. Median aortomesenteric angle and aorta-SMA distance were 22 and 6 mm, respectively. All patients improved on conservative treatment. In our series, a marked (>5 kg) weight loss ( ) and a long-standing presentation (more than six months in 80{\%} of patients) ( ) are signicantly related to a diagnosis of conrmed SMA syndrome at CECT aer an endoscopic suspicion. A “resembling postprandial distress syndrome dyspepsia” presentation may be helpful to the endoscopist in suspecting a latent SMA syndrome ( ). e narrowing of both the aortomesenteric angle ( ) and the aortomesenteric distance ( ) was signicantly associated with the diagnosis of SMA aer an endoscopic suspicion; however, the narrowing of the aortomesenteric distance seemed to be more accurate, rather than the narrowing of the aortomesenteric angle. Conclusion. SMA syndrome represents a diagnostic and therapeutic challenge. Our results show the following ndings: the importance of the endoscopic suspicion of SMA syndrome; the preponderance of a long-standing and chronic onset; a female preponderance; the importance of the nutritional counseling for the treatment; no need of surgical intervention; and better diagnostic accuracy of the narrowing of the aorta-SMA distance. Larger prospective studies are needed to clarify the best diagnosis and management of the SMA syndrome.",
author = "{Raimondo, D.; Albano, D.} and Giovanni Tomasello and Valentina Guarnotta",
year = "2018",
language = "English",
volume = "2018",
pages = "--",
journal = "Gastroenterology Research and Practice",
issn = "1687-6121",
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T1 - SUPERIOR MESENTERIC ARTERY SYNDROME: CLINICAL, ENDOSCOPIC AND RADIOLOGICAL FINDINGS

AU - Raimondo, D.; Albano, D.

AU - Tomasello, Giovanni

AU - Guarnotta, Valentina

PY - 2018

Y1 - 2018

N2 - Background. e superior mesenteric artery (SMA) syndrome is a rare entity presenting with upper gastrointestinal tract obstruction and weight loss. Studies to determine the optimal methods of diagnosis and treatment are required. Aims and Methods. is study aims at analyzing the clinical presentation, diagnosis, and management of SMA syndrome. Ten cases of SMA syndrome out of 2074 esophagogastroduodenoscopies were suspected. A contrast-enhanced computed tomography (CECT) scan was performed to conrm the diagnosis. Aer, a gastroenterologist and a nutritionist personalized the therapy. Furthermore, we compared the demographical, clinical, endoscopic, and radiological parameters of these cases with a control group consisting of 10 cases out of 2380 EGDS of initially suspected (but not radiologically conrmed) SMA over a follow-up 2-year period (2015-2016). Results. e prevalence of SMA syndrome was 0.005%. Median age and body mass index were 23.5 years and 21.5 kg/m , respectively. Symptoms developed between 6 and 24 months. Median aortomesenteric angle and aorta-SMA distance were 22 and 6 mm, respectively. All patients improved on conservative treatment. In our series, a marked (>5 kg) weight loss ( ) and a long-standing presentation (more than six months in 80% of patients) ( ) are signicantly related to a diagnosis of conrmed SMA syndrome at CECT aer an endoscopic suspicion. A “resembling postprandial distress syndrome dyspepsia” presentation may be helpful to the endoscopist in suspecting a latent SMA syndrome ( ). e narrowing of both the aortomesenteric angle ( ) and the aortomesenteric distance ( ) was signicantly associated with the diagnosis of SMA aer an endoscopic suspicion; however, the narrowing of the aortomesenteric distance seemed to be more accurate, rather than the narrowing of the aortomesenteric angle. Conclusion. SMA syndrome represents a diagnostic and therapeutic challenge. Our results show the following ndings: the importance of the endoscopic suspicion of SMA syndrome; the preponderance of a long-standing and chronic onset; a female preponderance; the importance of the nutritional counseling for the treatment; no need of surgical intervention; and better diagnostic accuracy of the narrowing of the aorta-SMA distance. Larger prospective studies are needed to clarify the best diagnosis and management of the SMA syndrome.

AB - Background. e superior mesenteric artery (SMA) syndrome is a rare entity presenting with upper gastrointestinal tract obstruction and weight loss. Studies to determine the optimal methods of diagnosis and treatment are required. Aims and Methods. is study aims at analyzing the clinical presentation, diagnosis, and management of SMA syndrome. Ten cases of SMA syndrome out of 2074 esophagogastroduodenoscopies were suspected. A contrast-enhanced computed tomography (CECT) scan was performed to conrm the diagnosis. Aer, a gastroenterologist and a nutritionist personalized the therapy. Furthermore, we compared the demographical, clinical, endoscopic, and radiological parameters of these cases with a control group consisting of 10 cases out of 2380 EGDS of initially suspected (but not radiologically conrmed) SMA over a follow-up 2-year period (2015-2016). Results. e prevalence of SMA syndrome was 0.005%. Median age and body mass index were 23.5 years and 21.5 kg/m , respectively. Symptoms developed between 6 and 24 months. Median aortomesenteric angle and aorta-SMA distance were 22 and 6 mm, respectively. All patients improved on conservative treatment. In our series, a marked (>5 kg) weight loss ( ) and a long-standing presentation (more than six months in 80% of patients) ( ) are signicantly related to a diagnosis of conrmed SMA syndrome at CECT aer an endoscopic suspicion. A “resembling postprandial distress syndrome dyspepsia” presentation may be helpful to the endoscopist in suspecting a latent SMA syndrome ( ). e narrowing of both the aortomesenteric angle ( ) and the aortomesenteric distance ( ) was signicantly associated with the diagnosis of SMA aer an endoscopic suspicion; however, the narrowing of the aortomesenteric distance seemed to be more accurate, rather than the narrowing of the aortomesenteric angle. Conclusion. SMA syndrome represents a diagnostic and therapeutic challenge. Our results show the following ndings: the importance of the endoscopic suspicion of SMA syndrome; the preponderance of a long-standing and chronic onset; a female preponderance; the importance of the nutritional counseling for the treatment; no need of surgical intervention; and better diagnostic accuracy of the narrowing of the aorta-SMA distance. Larger prospective studies are needed to clarify the best diagnosis and management of the SMA syndrome.

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M3 - Article

VL - 2018

SP - -

JO - Gastroenterology Research and Practice

JF - Gastroenterology Research and Practice

SN - 1687-6121

ER -