Vascular compression of the duodenum was first described in 1361 by Rokitansky. Subsequent reports have produced a plethora of synonyms pertaining to this controversial entity, among which arteriomesenteric duodenal compression, superior mesenteric artery syndrome, and Wilkie´s syndrome are most frequently encountered. This implies partial or complete obs-truction of the duodenum in its third part by extrinsic pressure from the overlying superior mesentric artery at ´the point where the third part of the duodenum passes between this vessel and the underlying aorta. It is manifested by intermittent high intestinal obstruction with gastric distention, postprandial or positional discomfort, bilious emesis, and weight loss. This is particularly important in the presence of coexisting peptic ulcer disease.
Recently we experienced one case of Wilkie´s syndrome in 37-year-old male who was admitted due to indigestion, nausea, vomiting, constipation, and weight loss. Upper gastro-intestinal series before his operation revealed persistent, extrinsic compression of the third portion of the duodenum. Duodenojejunostomy was performed which provided immediate and complete alleviation of his symptoms. We present this interesting, relatively infrequent case with the review of literatures.
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