Özet:

Background and Aims: Superior mesenteric artery syndrome is an uncommon but well-recognized clinical entity characterized by compression of the third, or transverse, portion of the duodenum against the aorta by the superior mesenteric artery, resulting in chronic, intermittent, or acute complete or partial duodenal obstruction. The treatment of this arteriomesenteric compression includes conservative measures and surgical intervention. The purpose of the present study was to evaluate our surgical management and outcomes of the patients with superior mesenteric artery syndrome. Materials and Methods: Between January 2000 and January 2006, the patients with superior mesenteric artery syndrome were retrospectively analyzed from the case records. Results: All four patients had a history of chronic abdominal pain, nausea, postprandial discomfort, vomiting, and weight loss. Diagnostic methods included barium esophagogastroduodenography, upper gastrointestinal endoscopy, and computed tomography. Medical management was administrated in all cases before surgery. Of those, three underwent duodenojejunostomy and one underwent gastroenterostomy. Postoperative period was uneventful and mean day of hospital discharge was postoperative day 6. Conclusions: Because the main problem is the narrowing of the aortomesenteric angle in patients with superior mesenteric artery syndrome, conservative initial treatment usually results in surgical intervention. Diagnosis of the pathology is the first step of the treatment, and superior mesenteric artery syndrome should be considered in the differential diagnosis in patients with chronic upper abdominal pain. Duodenojejunostomy is the most frequently used procedure with a high success rate.

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