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상장간막동맥증후군: 과거와 현재

Superior Mesenteric Artery Syndrome: Past and Present

  • 김의배 (순천향대학교 의과대학 내과학교실) ;
  • 이태희 (순천향대학교 의과대학 내과학교실)
  • Kim, Eui Bae (Institution for Digestive Research, Department of Internal Medicine, Soonchunhyang University Hospital) ;
  • Lee, Tae Hee (Institution for Digestive Research, Department of Internal Medicine, Soonchunhyang University Hospital)
  • 발행 : 2013.01.01

초록

Superior mesenteric artery syndrome (SMAS) is an uncommon disease resulting from compression of the third portion of the duodenum by the superior mesenteric artery. Typical symptoms of SMAS are anorexia, nausea, vomiting, early satiety, abdominal pain and postprandial fullness. The diagnosis requires radiologic studies in patients with symptoms suggestive of SMAS. Radiologic studies include upper gastrointestinal barium study, angiography, abdominal ultrasound, endoscopic ultrasound, computed tomography (CT), and magnetic resonance imaging. The SMA angle to the aorta is normally $45^{\circ}$ (range, $38-56^{\circ}$), whereas in SMAS, that SMA angle is decreased to 6 to $25^{\circ}$. Additionally, the distance between the SMA and the aorta normally ranges from 10 to 20 mm, whereas in SMAS this distance is decreased to 2 to 8 mm. Recently SMAS diagnosis has been most commonly confirmed by CT. Therapy of SMAS includes weight gain to increase the aortomesenteric angle, but surgery is indicated in symptomatic patients when conservative management failed. To date, laparoscopic duodenojejunostomy seems to be a first-choice surgical options.

키워드

참고문헌

  1. Rokitansky C. Handbuch der pathologischen Anatomie. 1st ed. Wien: Braumuller und Seidel, 1842;3:187.
  2. Wilkie D. Chronic duodenal ileus. Am J Med Sci 1927;173:643-649. https://doi.org/10.1097/00000441-192705000-00006
  3. Dietz UA, Debus ES, Heuko-Valiati L, et al. Aorto-mesenteric artery compression syndrome. Chirurg 2000;71:1345-1351. https://doi.org/10.1007/s001040051224
  4. Anderson WC, Vivit R, Kirsh IE, Greenlee HB. Arteriomesenteric duodenal compression syndrome: its association with peptic ulcer. Am J Surg 1973;125:681-689. https://doi.org/10.1016/0002-9610(73)90165-7
  5. Battilana A, Crespi B, Rabughino G, Mosca D, Mettini L. Two cases of duodenal vascular compression syndrome. Minerva Med 1989:80;815-820.
  6. Sapkas G, O'Brien JP. Vascular compression of the duodenum (cast syndrome) associated with the treatment of spinal deformities: a report of six cases. Arch Orthop Trauma Surg 1981;98:7-11. https://doi.org/10.1007/BF00389703
  7. Hohenfellner M, Steinbach F, Schultz-Lampel D, et al. The nutcracker syndrome: new aspects of pathophysiology, diagnosis and treatment. J Urol 1991;146:685-688. https://doi.org/10.1016/S0022-5347(17)37893-X
  8. Derrick JR, Fadhli HA. Surgical Anatomy of the Superior Mesenteric Artery. Am Surg 1965;31:545-547.
  9. Mansberger AR Jr, Hearn JB, Byers RM, Fleisig N, Buxton RW. Vascular compression of the duodenum: emphasis on accurate diagnosis. Am J Surg 1968;115:89-96. https://doi.org/10.1016/0002-9610(68)90134-7
  10. Wayne ER, Burrington JD. Duodenal obstruction by the superior mesenteric artery in children. Surgery 1972;72:762-768.
  11. Neri S, Signorelli SS, Mondati E, et al. Ultrasound imaging in diagnosis of superior mesenteric artery syndrome. J Intern Med 2005;257:346-351. https://doi.org/10.1111/j.1365-2796.2005.01456.x
  12. Hines JR, Gore RM, Ballantyne GH. Superior mesenteric artery syndrome: diagnostic criteria and therapeutic approaches. Am J Surg 1984;148:630-632. https://doi.org/10.1016/0002-9610(84)90339-8
  13. Welsch T, Buchler MW, Kienle P. Recalling superior mesenteric artery syndrome. Dig Surg 2007;24:149-156. https://doi.org/10.1159/000102097
  14. Gthrie RH Jr. Wilkie's syndrome. Ann Surg 1971;173:290-293. https://doi.org/10.1097/00000658-197102000-00017
  15. Froese AP, Szmuilowicz J, Bailey JD. The superior-mesenteric-artery syndrome: cause or complication of anorexia nervosa? Can Psychiatr Assoc J 1978;23:325-327. https://doi.org/10.1177/070674377802300508
  16. Anderson JR, Earnshaw PM, Fraser GM. Extrinsic compression of the third part of the duodenum. Clin Radiol 1982;33:75-81. https://doi.org/10.1016/S0009-9260(82)80358-9
  17. Edwards KC, Katzen BT. Superior mesenteric artery syndrome due to large dissecting abdominal aortic aneurysm. Am J Gastroenterol 1984;79:72-74.
  18. Goes RN, Coy CS, Amaral CA, Fagundes JJ, Medeiros RR. Superior mesenteric artery syndrome as a complication of ileal pouch-anal anastomosis: report of a case. Dis Colon Rectum 1995;38:543-544. https://doi.org/10.1007/BF02148857
  19. Ylinen P, Kinnunen J, Hockerstedt K. Superior mesenteric artery syndrome: a follow-up study of 16 operated patients. J Clin Gastroenterol 1989;11:386-391. https://doi.org/10.1097/00004836-198908000-00007
  20. Martorell R, Guestm. Operative treatment of the superior mesenteric artery syndrome. Am Surg 1961;27:681-685.
  21. Goin LS, Wilk SP. Intermittent arteriomesenteric occlusion of the duodenum. Radiology 1956;67:729-737. https://doi.org/10.1148/67.5.729
  22. Nugent FW, Braasch JW, Epstein H. Diagnosis and surgical treatment of arteriomesenteric obstruction of the duodenum. JAMA 1966;196:1091-1093. https://doi.org/10.1001/jama.1966.03100250101046
  23. Rosa-Jimenez F, Rodriguez Gonzalez FJ, Puente Gutierrez JJ, Munoz Sanchez R, Adarraga Cansino MD, Zambrana Garcia JL. Duodenal compression caused by superior mesenteric artery: study of 10 patients. Rev Esp Enferm Dig 2003;95:485-489, 480-484.
  24. Zhu ZZ, Qiu Y. Superior mesenteric artery syndrome following scoliosis surgery: its risk indicators and treatment strategy. World J Gastroenterol 2005;11:3307-3310. https://doi.org/10.3748/wjg.v11.i21.3307
  25. Altiok H, Lubicky JP, DeWald CJ, Herman JE. The superior mesenteric artery syndrome in patients with spinal deformity. Spine (Phila Pa 1976) 2005;30:2164-2170. https://doi.org/10.1097/01.brs.0000181059.83265.b2
  26. Reckler JM, Bruck HM, Munster AM, Curreri PW, Pruitt BA Jr. Superior mesenteric artery syndrome as a consequence of burn injury. J Trauma 1972;12:979-985. https://doi.org/10.1097/00005373-197211000-00008
  27. Park ES. Superior mesenteric artery syndrome due to gastroenteroptosis. J Korean Surg Soc 1967;9:373-375.
  28. Kim KO. A case of the superior mesenteric artery syndrome (Wilkie's syndrome) due to gastroenteroptosis. J Korean Surg Soc 1969;11:489-493.
  29. Sung SH, Won DY, Kim IY, Cho NC, Kim DS, Rhoe BS. Surgical management for superior mesentery artery syndrome in Korea. J Korean Surg Soc 2003;65:150-156.
  30. Lee TH, Lee JS, Jo Y, et al. Superior mesenteric artery syndrome: where do we stand today? J Gastrointest Surg 2012;16:2203-2211. https://doi.org/10.1007/s11605-012-2049-5
  31. Akin JT Jr, Gray SW, Skandalakis JE. Vascular compression of the duodenum: presentation of ten cases and review of the literature. Surgery 1976;79:515-522.
  32. Roy A, Gisel JJ, Roy V, Bouras EP. Superior mesenteric artery (Wilkie's) syndrome as a result of cardiac cachexia. J Gen Intern Med 2005;20:C3-C4. https://doi.org/10.1007/s11606-005-0237-7
  33. Biank V, Werlin S. Superior mesenteric artery syndrome in children: a 20-year experience. J Pediatr Gastroenterol Nutr 2006;42:522-525. https://doi.org/10.1097/01.mpg.0000221888.36501.f2
  34. McCue JD, Nath DS, Bennett BA. Image of the month: superior mesenteric artery syndrome. Arch Surg 2006;141:607-608. https://doi.org/10.1001/archsurg.141.6.607
  35. Wilson-Storey D, MacKinlay GA. The superior mesenteric artery syndrome. J R Coll Surg Edinb 1986;31:175-178.
  36. Kaiser GC, McKain JM, Shumacker JB Jr. The superior mesenteric artery syndrome. Surg Gynecol Obstet 1960;110:133-140.
  37. Lippl F, Hannig C, Weiss W, Allescher HD, Classen M, Kurjak M. Superior mesenteric artery syndrome: diagnosis and treatment from the gastroenterologist's view. J Gastroenterol 2002;37:640-643. https://doi.org/10.1007/s005350200101
  38. Gustafsson L, Falk A, Lukes PJ, Gamklou R. Diagnosis and treatment of superior mesenteric artery syndrome. Br J Surg 1984;71:499-501. https://doi.org/10.1002/bjs.1800710706
  39. Unal B, Aktas A, Kemal G, et al. Superior mesenteric artery syndrome: CT and ultrasonography findings. Diagn Interv Radiol 2005;11:90-95.
  40. Konen E, Amitai M, Apter S, et al. CT angiography of superior mesenteric artery syndrome. AJR Am J Roentgenol 1998;171:1279-1281. https://doi.org/10.2214/ajr.171.5.9798861
  41. Di Matteo F, Picconi F, Sansoni I, et al. Superior mesenteric artery syndrome diagnosed with linear endoscopic ultrasound. Endoscopy 2010;42(Suppl 2):E67-E68. https://doi.org/10.1055/s-0029-1215124
  42. Martin RJ, Khor TS, Vermeulen T, Hall J. Wilkie's syndrome may be due to poor motility. ANZ J Surg 2005;75:1027. https://doi.org/10.1111/j.1445-2197.2005.03603.x
  43. Sundaram P, Gupte GL, Millar AJ, McKiernan PJ. Endoscopic ultrasound is a useful diagnostic test for superior mesenteric artery syndrome in children. J Pediatr Gastroenterol Nutr 2007;45:474-476. https://doi.org/10.1097/MPG.0b013e31803e16f4
  44. Lee CS, Mangla JC. Superior mesenteric artery compression syndrome. Am J Gastroenterol 1978;70:141-150.
  45. Strong EK. Ann Surg 1958;148:725-730. https://doi.org/10.1097/00000658-195811000-00001
  46. Massoud WZ. Laparoscopic management of superior mesenteric artery syndrome. Int Surg 1995;80:322-327.
  47. Gersin KS, Heniford BT. Laparoscopic duodenojejunostomy for treatment of superior mesenteric artery syndrome. JSLS 1998;2:281-284.
  48. Munene G, Knab M, Parag B. Laparoscopic duodenojejunostomy for superior mesenteric artery syndrome. Am Surg 2010;76:321-324.

피인용 문헌

  1. Gastric Emphysema Related with Superior Mesenteric Artery Syndrome vol.37, pp.2, 2013, https://doi.org/10.12771/emj.2014.37.2.141
  2. Nutcracker Syndrome combined with Superior Mesenteric Artery Syndrome in a Pediatric Patient: A Case Report vol.22, pp.2, 2018, https://doi.org/10.3339/jkspn.2018.22.2.75