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Superior Mesenteric Artery Syndrome

Superior Mesenteric Artery Syndrome Abstract Recurrent abdominal pain is common in pediatric practice. Frequently no organic cause is established after extensive clinical and laboratory studies. It is the purpose of this report to call attention to the superior mesenteric artery syndrome (SMAS) as a cause of abdominal pain and to discuss its pathogenesis, diagnosis, and treatment. The SMAS is an obstruction of the duodenum in the transverse portion proximal to the ligament of Treitz. It is produced by the dorsal mesentery which includes the superior mesenteric artery with its accompanying veins, nerves, fibrous tissue, fat, and lymph nodes. Obstruction varies from minimal to complete. It is intermittent to constant and may be symptomatic or asymptomatic. The symptoms and signs produced by SMAS are similar to those due to any duodenal obstruction distal to the ampulla of Vater. Organic obstruction in the distal duodenum by the SMAS was first reported by von Rokitansky1 in 1861. References 1. von Rokitansky, C.: Lehrbuch der Pathologischen Anatomie, Wien, Braumüller, 1861, p. 187. 2. Albrecht, P. S.: Virchow Arch Path Anat 156:285, 1889.Crossref 3. Bockus, H. L.: Chronic Duodenal Stasis , Penn Med J 32:610, 1929. 4. Widman, B. P.: The Roentgen Diagnosis of Chronic Duodenal Stasis , Penn Med J 32:631, 1929. 5. Wilkie, D. P. D.: Chronic Duodenal Ileus , Brit J Surg 9:204, 1921.Crossref 6. Rosenburg, S. A., and Sampson, A.: The Syndrome of Mesenteric Vascular Compression of the Duodenum , AMA Arch Surg 73:296, 1956.Crossref 7. Rabinovitch, J.; Pines, B., and Felton, M.: Superior Mesenteric Artery Syndrome , JAMA 179:257, 1962.Crossref 8. Tyson, W. T., and Keegan, J. M.: Duodenal Obstruction Due to Compression of the Superior Mesentery Root , JAMA 165:1667, 1957. 9. Lontok, R. M., and Taber, K. W.: Arteriomesenteric Duodenal Occlusion: Eight Proven Cases , Penn Med J 62:1529, 1959. 10. Lu, J. L., and Cole, G. M.: Chronic Duodenal Ileus Due to Chronic Arteriomesenteric Occlusion , AMA Arch Surg 73:1022, 1956.Crossref 11. Wangensteen, O. H.: Intestinal Obstructions , Ed. 3, Springfield, Ill., Charles C Thomas, 1955, p. 554. 12. Berley, F. V., and Brown, R. B.: Arteriomesenteric Obstruction of the Duodenum , US Armed Forces Med J 5:1044, 1954. 13. Kaiser, G. C.; McKain, J. M., and Shumacker, M. B.: The Superior Mesenteric Artery Syndrome , Surg Gynec Obstet 110:133, 1960. 14. Roodenburg, A. I., and Boden, G. F.: Obstruction of the Third Portion of the Duodenum Caused by Compression by the Superior Mesenteric Blood Vessels , New York J Med 53:2693, 1953. 15. Kauffman, R. R., and Gerbode, F.: Arteriomesenteric Duodenal Ileus , Stanford Med Bull 9:262, 1951. 16. Schaffer, E. V.: The Cast Syndrome: Modern Med (Minneap) 30:20, 1962. 17. Jones, S. A.; Carter, R.; Smith, L. L., and Joergenson, E. J.: Arteriomesenteric Duodenal Compression , Amer J Surg 100:262, 1960.Crossref 18. Prouty, M., and Waskow, W. L.: Duodenal Compression by the Mesenteric Artery , J. Pediat 50:734, 1957.Crossref 19. Strong, E. K.: Mechanics of Arteriomesenteric Duodenal Obstruction and Direct Surgical Attack Upon Etiology , Ann Surg 148:725, 1958.Crossref 20. Major, J. W.; Ottenheimer, E. J., and Whalen, W. A.: Duodenal Obstruction at the Ligament of Treitz , New Engl J Med 262:443, 1960.Crossref 21. Eek, S.: Congenital Duodenal Obstruction: Clinical, Roentgenological, Surgical, and Follow-up Study in 29 Cases , Amer J Roentgenol 73:713, 1955. 22. Licht, E. de Fine: Arterio-Mesenteric Obstruction of the Duodenum in Adult Life and Adolescence , Acta Radiol (Stockh) 45:441, 1956.Crossref 23. Goin, L. S., and Wilk, S. P.: Intermittent Adolescence , Acta Radiol (Stockh) 45:441, 1956.Crossref 24. Radiology 67:729, 1956.Crossref 25. Romagosa, J., and Menville, L. J.: Chronic Intermittent Arteriomesenteric Occlusion of the Duodenum , Radiology 57:63, 1951.Crossref 26. Bitner, W. P.: Arteriomesenteric Occlusion of the Duodenum , Amer J Roentgenol 79:807, 1958. 27. Cunha, F., and Day, B. M.: Duodenal Stasis Caused by an Aberrant Superior Mesenteric Vessel , Amer J Gastroent 21:121, 1954. 28. Caffey, J.: Pediatric X-Ray Diagnosis , Ed. 4, Chicago, Year Book Medical Publishers, Inc., p. 591, 1961. 29. Gray, H.: Anatomy of the Human Body , Ed. 27, edited by C. M. Goss, Philadelphia, Lea & Febiger, 1959, p. 1279. 30. Cunningham, D. J.: Manual of Pratical Anatomy , Ed. 9, edited by J. C. Brash, London, Oxford University Press, 1951, p. 633. 31. Bliss, E. L., and Branch, C. H. H.: Anorexia Nervosa: Its History , Psychology and Biology , New York, Paul B. Hoeber, Inc., 1960. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Superior Mesenteric Artery Syndrome

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References (17)

Publisher
American Medical Association
Copyright
Copyright © 1963 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1963.02080050027007
Publisher site
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Abstract

Abstract Recurrent abdominal pain is common in pediatric practice. Frequently no organic cause is established after extensive clinical and laboratory studies. It is the purpose of this report to call attention to the superior mesenteric artery syndrome (SMAS) as a cause of abdominal pain and to discuss its pathogenesis, diagnosis, and treatment. The SMAS is an obstruction of the duodenum in the transverse portion proximal to the ligament of Treitz. It is produced by the dorsal mesentery which includes the superior mesenteric artery with its accompanying veins, nerves, fibrous tissue, fat, and lymph nodes. Obstruction varies from minimal to complete. It is intermittent to constant and may be symptomatic or asymptomatic. The symptoms and signs produced by SMAS are similar to those due to any duodenal obstruction distal to the ampulla of Vater. Organic obstruction in the distal duodenum by the SMAS was first reported by von Rokitansky1 in 1861. References 1. von Rokitansky, C.: Lehrbuch der Pathologischen Anatomie, Wien, Braumüller, 1861, p. 187. 2. Albrecht, P. S.: Virchow Arch Path Anat 156:285, 1889.Crossref 3. Bockus, H. L.: Chronic Duodenal Stasis , Penn Med J 32:610, 1929. 4. Widman, B. P.: The Roentgen Diagnosis of Chronic Duodenal Stasis , Penn Med J 32:631, 1929. 5. Wilkie, D. P. D.: Chronic Duodenal Ileus , Brit J Surg 9:204, 1921.Crossref 6. Rosenburg, S. A., and Sampson, A.: The Syndrome of Mesenteric Vascular Compression of the Duodenum , AMA Arch Surg 73:296, 1956.Crossref 7. Rabinovitch, J.; Pines, B., and Felton, M.: Superior Mesenteric Artery Syndrome , JAMA 179:257, 1962.Crossref 8. Tyson, W. T., and Keegan, J. M.: Duodenal Obstruction Due to Compression of the Superior Mesentery Root , JAMA 165:1667, 1957. 9. Lontok, R. M., and Taber, K. W.: Arteriomesenteric Duodenal Occlusion: Eight Proven Cases , Penn Med J 62:1529, 1959. 10. Lu, J. L., and Cole, G. M.: Chronic Duodenal Ileus Due to Chronic Arteriomesenteric Occlusion , AMA Arch Surg 73:1022, 1956.Crossref 11. Wangensteen, O. H.: Intestinal Obstructions , Ed. 3, Springfield, Ill., Charles C Thomas, 1955, p. 554. 12. Berley, F. V., and Brown, R. B.: Arteriomesenteric Obstruction of the Duodenum , US Armed Forces Med J 5:1044, 1954. 13. Kaiser, G. C.; McKain, J. M., and Shumacker, M. B.: The Superior Mesenteric Artery Syndrome , Surg Gynec Obstet 110:133, 1960. 14. Roodenburg, A. I., and Boden, G. F.: Obstruction of the Third Portion of the Duodenum Caused by Compression by the Superior Mesenteric Blood Vessels , New York J Med 53:2693, 1953. 15. Kauffman, R. R., and Gerbode, F.: Arteriomesenteric Duodenal Ileus , Stanford Med Bull 9:262, 1951. 16. Schaffer, E. V.: The Cast Syndrome: Modern Med (Minneap) 30:20, 1962. 17. Jones, S. A.; Carter, R.; Smith, L. L., and Joergenson, E. J.: Arteriomesenteric Duodenal Compression , Amer J Surg 100:262, 1960.Crossref 18. Prouty, M., and Waskow, W. L.: Duodenal Compression by the Mesenteric Artery , J. Pediat 50:734, 1957.Crossref 19. Strong, E. K.: Mechanics of Arteriomesenteric Duodenal Obstruction and Direct Surgical Attack Upon Etiology , Ann Surg 148:725, 1958.Crossref 20. Major, J. W.; Ottenheimer, E. J., and Whalen, W. A.: Duodenal Obstruction at the Ligament of Treitz , New Engl J Med 262:443, 1960.Crossref 21. Eek, S.: Congenital Duodenal Obstruction: Clinical, Roentgenological, Surgical, and Follow-up Study in 29 Cases , Amer J Roentgenol 73:713, 1955. 22. Licht, E. de Fine: Arterio-Mesenteric Obstruction of the Duodenum in Adult Life and Adolescence , Acta Radiol (Stockh) 45:441, 1956.Crossref 23. Goin, L. S., and Wilk, S. P.: Intermittent Adolescence , Acta Radiol (Stockh) 45:441, 1956.Crossref 24. Radiology 67:729, 1956.Crossref 25. Romagosa, J., and Menville, L. J.: Chronic Intermittent Arteriomesenteric Occlusion of the Duodenum , Radiology 57:63, 1951.Crossref 26. Bitner, W. P.: Arteriomesenteric Occlusion of the Duodenum , Amer J Roentgenol 79:807, 1958. 27. Cunha, F., and Day, B. M.: Duodenal Stasis Caused by an Aberrant Superior Mesenteric Vessel , Amer J Gastroent 21:121, 1954. 28. Caffey, J.: Pediatric X-Ray Diagnosis , Ed. 4, Chicago, Year Book Medical Publishers, Inc., p. 591, 1961. 29. Gray, H.: Anatomy of the Human Body , Ed. 27, edited by C. M. Goss, Philadelphia, Lea & Febiger, 1959, p. 1279. 30. Cunningham, D. J.: Manual of Pratical Anatomy , Ed. 9, edited by J. C. Brash, London, Oxford University Press, 1951, p. 633. 31. Bliss, E. L., and Branch, C. H. H.: Anorexia Nervosa: Its History , Psychology and Biology , New York, Paul B. Hoeber, Inc., 1960.

Journal

American Journal of Diseases of Children – American Medical Association

Published: Jul 1, 1963

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