superior mesenteric artery compression syndrome
Introduction
Introduction to superior mesenteric artery compression syndrome Superior Mesenteric Artery Compression Syndrome, also known as Wilkie disease, is a series of symptoms of duodenal partial or complete obstruction caused by the superior mesenteric artery pressing the duodenum. . Most of the patients are young and middle-aged women, but also in patients with rapid weight loss, prolonged bed rest or spine protrusion. The clinical manifestations are recurrent epigastric pain and vomiting. In severe cases, surgery is needed and the prognosis is good. basic knowledge The proportion of illness: 0.002% Susceptible people: no specific population Mode of infection: non-infectious Complications: intestinal obstruction malnutrition
Cause
Cause of superior mesenteric artery compression syndrome
The anatomical features of the duodenum, superior mesenteric artery and abdominal aorta are closely related to the occurrence of this disease. Under normal conditions, the duodenum is located on the abdominal aorta and its forward branches are on the mesenteric Among the angles of the arteries, the front of the duodenum is the oblique superior mesenteric artery, followed by the celiac artery and the spine. The angle between the normal person through angiography is 47-60°, when the mesentery is too long, the internal organs Drooping, anterior tilt of the spine and variation of the superior mesenteric artery itself can cause the mesentery to pull down, making the angle smaller, often <6 ~ 25 ° and compressing the horizontal part of the duodenum, forming a narrowing of the intestine. The symptoms of duodenal obstruction appear.
Prevention
Prevention of superior mesenteric artery compression syndrome
For patients with fever, especially children and young adults, if they have prodromal symptoms of upper respiratory tract infection, they should immediately take antiviral and anti-infective treatments to prevent acute non-specific mesenteric diseases.
Complication
Complication of superior mesenteric artery compression syndrome Complications, intestinal obstruction, malnutrition
Easy to have intestinal stenosis, intestinal obstruction, duodenal obstruction, malnutrition, etc.
Symptom
Symptoms of superior mesenteric artery compression syndrome Common symptoms Mechanical compression, abdominal distension, weight loss, nausea and dehydration
According to intermittent abdominal distension, nausea and vomiting, symptoms and body position, increased in supine position, prone position, lateral position relief, and X-ray angiography showed signs of compression in the duodenal horizontal section, B-mode ultrasound or angiography Examination can generally make a diagnosis when the angle between the superior mesenteric artery and the abdominal aorta is reduced.
The disease can occur at any age, but it is more common in young and middle-aged women who are thin or long-term bedridden. It is chronic intermittent disease, which can be relieved after several days. Occasionally, the acute clinical manifestations are twelve. Refers to the performance of intestinal obstruction, after eating, the upper abdomen is full, pain, followed by nausea and vomiting, vomiting is large, similar to pyloric obstruction, the prominent feature of this disease is the symptoms and body position, in the supine position due to the symptoms of backward compression In the prone position, knee chest position, left side position can relieve symptoms, severe obstruction may be accompanied by dehydration and electrolyte imbalance, recurrent patients may have weight loss, anemia and other malnutrition, and some have neurosis symptoms .
Examine
Examination of superior mesenteric artery compression syndrome
1. X-ray angiography of the intestine: no abnormal findings were found during the remission period, duodenal compression signs were seen during the attack period, and longitudinally knife-like blocks or waterfalls were found at the center of the third segment (horizontal end). The sputum is slow to stay in the duodenum for more than 6 hours, the proximal end of the intestine is dilated, and is related to the change of body position, 20% may be associated with gastric dilatation.
2. B-mode ultrasound examination: Some people think that timed ultrasound imaging has a higher diagnostic value, and type B ultrasound shows a "bucket shape" or "cucurbit shape" image.
Diagnosis
Diagnosis and differentiation of superior mesenteric artery compression syndrome
Diagnostic criteria
1 The maximum width of the duodenal transverse intestine in the angle between the superior mesenteric artery and the aorta after drinking water is <10mm.
2 Duodenal descending segmental dilatation, internal meridian > 30mm.
Type 3B ultrasound displays a "bucket shape" or "cucurbit shape" image.
4 The angle between the aorta and the superior mesenteric artery is <13°.
Differential diagnosis
Should be noted with other diseases that cause duodenal stasis, such as duodenal tumors, stones, parasites and other lesions outside the duodenum (such as tumors, cysts) and so on.
