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SMA syndrome is also known as Wilkie's syndrome, cast syndrome, mesenteric root syndrome, chronic duodenal ileus and intermittent arterio-mesenteric occlusion. [3] It is distinct from nutcracker syndrome, which is the entrapment of the left renal vein between the AA and the SMA, although it is possible to be diagnosed with both conditions. [4]
Acute occlusion of the SMA almost invariably leads to intestinal ischemia and often has devastating consequences, with up to 80% of SMA occlusions leading to death. [2] The SMA can compress the left renal vein, leading to nutcracker syndrome; and/or the third (horizontal) part of the duodenum, leading to superior mesenteric artery syndrome.
Arterial occlusion is a condition involving partial or complete blockage of blood flow through an artery. Arteries are blood vessels that carry oxygenated blood to body tissues. [ 1 ] [ 2 ] An occlusion of arteries disrupts oxygen and blood supply to tissues, leading to ischemia . [ 1 ]
In those with chronic disease bypass surgery is the treatment of choice. [1] Those who have thrombosis of the vein may be treated with anticoagulation such as heparin and warfarin, with surgery used if they do not improve. [2] [8] Acute intestinal ischemia affects about five per hundred thousand people per year in the developed world. [4]
The left colic artery is a branch of the inferior mesenteric artery distributed to the descending colon, and left part of the transverse colon.It ends by dividing into an ascending branch and a descending branch; [1] the terminal branches of the two branches go on to form anastomoses with the middle colic artery, and a sigmoid artery (respectively).
[17] [18] If blood flow to the colon drops by more than about 50%, ischemia will develop. The arteries feeding the colon are very sensitive to vasoconstrictors; presumably this is an evolutionary adaptation to shunt blood away from the bowel and to the heart and brain in times of stress. [19]
Colorectal surgery is a field in medicine dealing with disorders of the rectum, anus, and colon. [1] The field is also known as proctology , but this term is now used infrequently within medicine and is most often employed to identify practices relating to the anus and rectum in particular.
Depending on the level of obstruction, bowel obstruction can present with abdominal pain, abdominal distension, and constipation.Bowel obstruction may be complicated by dehydration and electrolyte abnormalities due to vomiting; respiratory compromise from pressure on the diaphragm by a distended abdomen, or aspiration of vomitus; bowel ischemia or perforation from prolonged distension or ...