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Genetic and Rare Diseases Information Center (GARD)

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Superior mesenteric artery syndrome


Other Names for this Disease

  • Arteriomesenteric duodenal compression syndrome
  • Cast syndrome
  • Vascular compression of the duodenum
  • Wilkie syndrome
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.

Your Question

I have been recently diagnosed with superior mesenteric artery syndrome. Can you provide me with information about this condition?

Our Answer

We have identified the following information that we hope you find helpful. If you still have questions, please contact us.

What is the superior mesenteric artery?

The superior mesenteric artery is a large artery in the abdominal cavity that provides blood to the small intestine, cecum, and colon. The small intestine is the portion of the digestive system most responsible for absorption of nutrients from food into the bloodstream.[1]  Click here to view a diagram of the superior mesenteric artery from the MERCK Manual Web site.

The superior mesenteric artery makes its way between two layers of the mesentery (membranous tissue which carries blood vessels and lymph glands and attaches organs to the abdominal wall) and crosses over the first part of the small intestine, called the duodenum.  The duodenum is where partly digested foods from the stomach mix with bile from the gall bladder and digestive juices from the pancreas.[2]

Last updated: 7/26/2012

What is superior mesenteric artery syndrome?

Superior mesenteric artery syndrome (SMAS) is a digestive condition that occurs when the duodenum (the first part of the small intestine) is compressed between two arteries (the aorta and the superior mesenteric artery). This compression causes partial or complete blockage of the duodenum.[3] Signs and symptoms may include abdominal fullness; bloating after meals; nausea and vomiting; and abdominal cramping that may be helped by lying in certain positions. A variety of factors may contribute to SMAS, including prolonged bed rest, weight loss, rapid growth, previous abdominal surgery, lordosis, use of body casts, and loss of tone in abdominal muscles. It may also occur with pancreatitis, peptic ulcers, and other inflammatory abdominal conditions.[4] Treatment may include addressing the underlying cause and/or dietary modifications (small feedings or a liquid diet).[4][3]
Last updated: 12/11/2014

What are the signs and symptoms of superior mesenteric artery syndrome?

The signs and symptoms of superior mesenteric artery syndrome vary but may include:[4]

  • Abdominal fullness
  • Bloating after meals
  • Nausea and vomiting of partially digested food
  • Mid-abdominal "crampy" pain that may be relieved by the prone or knee-chest position.
Last updated: 12/11/2014

What causes superior mesenteric artery syndrome?

A variety of factors can contribute to the development of superior mesenteric artery syndrome (SMAS), including:[4]
  • prolonged bed rest
  • rapid, severe weight loss
  • rapid growth
  • previous abdominal surgery
  • lordosis
  • use of body casts
  • loss of tone in abdominal muscles

SMAS has also been reported to occur in some people with pancreatitis, peptic ulcers, and other inflammatory conditions of the abdomen.[4] Rarely, the condition may be caused by an abnormality in the structure of the body (such as unusual position or location of the artery). Familial SMAS, recurrent SMAS, and idiopathic neonatal SMAS have also been reported.[3]

Last updated: 12/11/2014

How might superior mesenteric artery syndrome be treated? 

Treatment for superior mesenteric artery syndrome typically focuses on addressing the underlying cause of the condition.[3] For example, symptoms often improve after lost weight is restored or a body cast is removed.[4] Nasogastric decompression (a tube passed through the nose into the stomach) and proper positioning after eating (such as lying prone and knee-to-chest position) may be recommended to alleviate symptoms.[3]

In severe cases, intravenous (IV) nutritional support and/or a feeding tube may be needed to provide enough calories. Affected people can usually then be started on oral liquids, followed by slow and gradual introduction of small and frequent soft meals as tolerated. Then, regular solid foods may be introduced. Metoclopramide treatment may be beneficial for some people.[3]

Surgery may be needed if other treatment strategies do not work. However, other treatment options should usually be tried for at least 4-6 weeks before considering surgery.[3]
Last updated: 12/11/2014

References
Other Names for this Disease
  • Arteriomesenteric duodenal compression syndrome
  • Cast syndrome
  • Vascular compression of the duodenum
  • Wilkie syndrome
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.