What’s superior mesenteric artery syndrome?

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Superior mesenteric artery syndrome is a potentially life-threatening condition affecting 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 medication, rest, and a feeding tube, but chronic problems often require surgery to prevent serious complications.

The duodenum is located between the superior mesenteric artery and the abdominal aorta. If the superior artery is angled strongly inward, it can put pressure on the duodenum and impair digestion. Superior mesenteric artery syndrome can be caused by a birth 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 stomach or lower back surgery. Females and especially lean males between the ages of 10 and 30 are at the highest risk of developing the condition, but birth defects can cause problems at a young age.

Symptoms of this disorder can come on suddenly or get progressively 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 worse when lying on your back, and pains are usually slightly relieved when lying on your stomach.

Complications can be life threatening if the condition is not recognized and treated thoroughly. An individual may become malnourished or dehydrated due to eating difficulties and associated gastrointestinal problems. It’s also possible for the duodenum or stomach to rupture under constant pressure. A person experiencing sudden or worsening stomach pain should visit a doctor as soon as possible.

It is possible for a doctor to misdiagnose superior mesenteric artery syndrome after an initial evaluation as it is a very rare disease. By carefully examining the results of imaging tests, a specialist can usually confirm that the artery is indeed skewed and is compressing the duodenum. Patients with acute superior mesenteric artery syndrome are typically hospitalized, placed on their side, and provided with feeding tubes. Intravenous medications and fluids help 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 make a full recovery within about six months.

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