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Niasse A, Faye PM, Ndong A, Kuadjovi SR, Leye A, Diack ND, Gueye ML, Thiam O, Ndiaye M, Diouf A, Sarr ISS, Seye Y, Toure AO, Seck M, Cisse M, Dieng M. [Superior mesenteric artery syndrome in gastric cancer: a case report]. Pan Afr Med J 2022; 42:217. [PMID: 36845233 PMCID: PMC9949278 DOI: 10.11604/pamj.2022.42.217.27281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 12/16/2020] [Indexed: 11/11/2022] Open
Abstract
Superior mesenteric artery syndrome or Wilkie syndrome is due to the compression of the third duodenum between the superior mesenteric artery and the aorta. It causes acute or chronic upper bowel occlusion. Abdominal CT scan facilitates the diagnosis. Severe malnutrition is its main etiological factor. Medical treatment can be based on aspiration of gastric contents and parenteral nutrition. If this fails, surgery is necessary. We here report the case of a 46-year-old patient, with a history of smoking, presenting with profuse postprandial bile and food vomiting. He had had weight loss of 7% over a period of 6 months. Upper GI endoscopy revealed non-stenotic antro-pyloric tumour mass. Histological examination showed poorly differentiated tubular gastric adenocarcinoma. Staging was without any peculiarity and allowed for the detection of superior mesenteric artery syndrome at an angle of 8°C. The patient received parenteral nutrition for 10 days, followed by inferior pole gastrectomy and gastrojejunal anastomosis (omega loop). The postoperative course was uneventful. Adjuvant chemotherapy was indicated.
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Affiliation(s)
- Abdou Niasse
- Service de Chirurgie, Centre Hospitalier National de Pikine, Dakar, Sénégal
| | - Papa Mamadou Faye
- Service de Chirurgie Générale, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal
| | - Abdourahmane Ndong
- Service de Chirurgie Générale, Hôpital Régional de Saint-Louis, Saint-Louis, Sénégal
| | | | - Abdoulaye Leye
- Service de Médecine Interne, Centre Hospitalier National de Pikine, Dakar, Sénégal
| | - Ngoné Diaba Diack
- Service de Médecine Interne, Centre Hospitalier National de Pikine, Dakar, Sénégal
| | - Mohamadou Lamine Gueye
- Service de Chirurgie Générale, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal
| | - Ousmane Thiam
- Service de Chirurgie Générale, Centre Hospitalier Universitaire Dalal Jamm, Dakar, Sénégal
| | - Mamadou Ndiaye
- Service de Chirurgie Générale, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal
| | - Ahmed Diouf
- Service de Chirurgie Générale, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal
| | | | - Yacine Seye
- Service de Chirurgie Générale, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal
| | - Alpha Oumar Toure
- Service de Chirurgie Générale, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal
| | - Mamadou Seck
- Service de Chirurgie Générale, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal
| | - Mamadou Cisse
- Service de Chirurgie Générale, Centre Hospitalier Universitaire Dalal Jamm, Dakar, Sénégal
| | - Madieng Dieng
- Service de Chirurgie Générale, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal
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Beltrán ODG, Martínez AV, Manrique MDCP, Rodríguez JS, Febres EL, Peña SR. Superior mesenteric artery syndrome in a patient with Charcot Marie Tooth disease. World J Gastrointest Surg 2011; 3:197-200. [PMID: 22224174 PMCID: PMC3251743 DOI: 10.4240/wjgs.v3.i12.197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Revised: 11/03/2011] [Accepted: 11/10/2011] [Indexed: 02/06/2023] Open
Abstract
The extrinsic compression of the third part of the duodenum as it passes through the aorto-mesenteric angle is known as the superior mesenteric artery syndrome (SMAS). This syndrome is a rare mechanical cause of upper intestinal obstruction, with a reported incidence of between 0.2% and 0.78%. Clinical manifestations of SMAS may be chronic or acute; chronic symptoms include intermittent gastric pain, fullness and occasional episodes of postprandial vomiting, while acute symptoms include incoercible vomiting, oral intolerance, mainly epigastric abdominal distension and abdominal pain. Surgery is recommended only when initial conservative treatment fails. Here, we report what appears to be the third published case of SMAS associated with hereditary motor and sensory neuropathy or Charcot Marie Tooth disease.
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Affiliation(s)
- Oscar Dario Gómez Beltrán
- Óscar Dario Gómez Beltrán, Amparo Valverde Martínez, María del Carmen Pérez Manrique, Joaquín Sánchez Rodríguez, Enrique Lizárraga Febres, Sebastián Rufián Peña, Department of General Surgery, Reina Sofía Teaching Hospital, Córdoba 14004, Spain
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