The arteriomesenteric duodenal compression syndrome was first described by Rokitansky more than 100 years ago. It is known by many names in the literature, including Wilkies syndrome, superior mesenteric artery syndrome, cast syndrome and chronic
duodenal obstruction. In is a symtom complex caused by intermittent obstruction of the third portion of the duodenum, where it is crossed by the superior mesenior mesenteric artery as it descends from the abdominal aorta. This obstruction can
usually be
demonstrated radiographically. Typical symtoms include postprandial epigastric distress, vomiting, weight loss, and partial relief of the obstruction by the knee-chest position and left lateral decubitus position. The cause of the compression is
generally considered to be the viselike effect produced as a result of the angle formed by the superior mesenteric vessels with the aorta. Depletion of mesenteric fat appears to further close this angle as does lordosis, prolonged supine
position,
and
viceroptosis. Such factors as these increase the obstruction with resulting reduction in food intake and vicious cycle ensues. The contributing factors include body casting with weakening of abdominal musculature. malrotation of the intestine,
megaureter, congenital decrease of the angle between the superior mesenteric artery and the aorta, and hypertrophy of the ligament of Treitz.
We experienced 2 cases of SMA syndrome and reported it with reveiw of the literatures.
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