Superior mesenteric artery compression syndrome

Superior mesenteric artery compression syndrome refers to acute or chronic intestinal obstruction caused by compression of the horizontal portion of the duodenum by the superior mesenteric artery, also known as superior mesenteric artery syndrome, duodenal vascular compression syndrome, benign duodenal stasis syndrome, or Wilkie syndrome. In orthopedics, after immobilization with a body cast or hip spica cast, patients often develop acute superior mesenteric artery compression syndrome due to the hyperextended posture, hence it is also called cast syndrome. This condition can occur at any age, and is more common in young and middle-aged individuals with a lean, tall body type. Based on the onset, it can be classified into acute and chronic types. In chronic patients, symptom onset is related to posture, and patients can often alleviate discomfort by changing positions, such as lying on the side, lying prone, assuming the knee-chest position, sitting leaning forward, or placing both knees under the chin. Conversely, the supine position can worsen symptoms. Acute superior mesenteric artery compression syndrome is relatively rare, with causes mostly related to trauma and iatrogenic factors. Its symptoms are similar to those of the chronic type, but are persistent and severe, with frequent and copious vomiting. In terms of treatment, options include conservative management, surgical treatment, and interventional therapy. Except for cases caused by factors such as aneurysms that require immediate surgery or interventional treatment, conservative treatment should be adopted first during the acute episode, including fasting, gastrointestinal decompression, maintenance of water, electrolyte, and acid-base balance, and nutritional support, with total parenteral nutrition used when necessary.