What is Superior Mesenteric Artery Syndrome?

D. Jeffress

Superior mesenteric artery syndrome is a potentially life-threatening condition that affects the gastrointestinal tract. It occurs when the duodenum, the part of the small intestine that connects to the stomach, is compressed by a large artery in the abdomen. The condition can be acute or chronic, and symptoms can potentially arise at any age. Most acute cases can be treated with medications, rest, and a feeding tube, but chronic problems often necessitate surgery to prevent serious complications.

Medication may be required to treat superior mesenteric artery syndrome.
Medication may be required to treat superior mesenteric artery syndrome.

The duodenum is situated between the superior mesenteric artery and the abdominal aorta. If the superior artery is angled steeply inward, it can put pressure on the duodenum and impair digestion. Superior mesenteric artery syndrome may be caused by a congenital defect of the stomach or artery, severe trauma to the abdomen, or prolonged periods of bed rest or immobilization. Occasionally, patients experience the condition after undergoing surgery on their stomachs or lower backs. Females and especially thin males between the ages of 10 and 30 are at the highest risk of developing the condition, but congenital defects can cause problems at a younger age.

Rest may help treat superior mesenteric artery syndrome.
Rest may help treat superior mesenteric artery syndrome.

Symptoms of this disorder may come about suddenly or progressively get worse over several months. The most common symptoms are stomach cramps, constant abdominal pain, nausea, and belching. A person may feel full after very small meals and vomit frequently. Symptoms tend to be the worst when lying on the back, and pains are usually relieved somewhat when lying on the stomach.

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Surgery may be required to treat superior mesenteric artery syndrome.
Surgery may be required to treat superior mesenteric artery syndrome.

Complications can be deadly if the condition is not recognized and treated accurately. An individual may become malnourished or dehydrated due to difficulties eating and accompanying gastrointestinal problems. It is also possible for the duodenum or stomach to rupture under constant pressure. A person who experiences sudden or worsening stomach pains should visit a doctor as soon as possible.

Belching is a common symptom of mesenteric artery syndrome.
Belching is a common symptom of mesenteric artery syndrome.

It is possible for a physician to misdiagnose superior mesenteric artery syndrome upon an initial evaluation since it is a very rare disorder. By carefully reviewing the results of diagnostic imaging tests, a specialist can usually confirm that the artery is indeed angled and compressing the duodenum. Patients with acute superior mesenteric artery syndrome are typically hospitalized, placed on their sides, and given feeding tubes. Intravenous medications and fluids help to stimulate the gastrointestinal tract and prevent dehydration.

Superior mesenteric artery syndrome occurs when the duodenum is compressed by a large artery in the abdomen.
Superior mesenteric artery syndrome occurs when the duodenum is compressed by a large artery in the abdomen.

Chronic and congenital problems are usually treated with surgery. If a defect is minor, a surgeon may be able to manually realign the artery and duodenum. In most cases, however, a procedure called a duodenojejunostomy is needed to bypass the compressed section and connect a lower part of the intestine to the stomach. Surgical repair has a high success rate, and most patients are able to fully recover within about six months.

Stomach cramps and abdominal pain are common symptoms of superior mesenteric artery syndrome.
Stomach cramps and abdominal pain are common symptoms of superior mesenteric artery syndrome.
A diagram of the aorta, including the superior mesenteric artery.
A diagram of the aorta, including the superior mesenteric artery.

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Discussion Comments

anon992686

I was finally diagnosed with it too, but I would not let them operate on me.

anon989575

I fully agree with anon350058 and the others above. Our story sounds very close to the same experience. My first emergency surgery and SMAS diagnosis was in Sept. 2003. After 10+ years of tests that showed nothing.

I have a G-tube Mik-Key button to my stomach on my left side and a J-tube red rubber catheter on the right side to my lower intestine. I've had four SMAS related surgeries, so far. In June/July 2014, I had an Open Cholecystectomy (gall bladder removal, the hard way!). I also struggle to get my weight to 135 (currently at 129) and I'm 6'2" tall. My SMAS is congenital as well. I'm wondering if you are Male or Female.

I'm a Male and it makes it more rare. I wish there was a way we could message past this page. But I don't know how to do that. I wish all of you, the best days possible and better health! My experience is, even with surgery or four, there is really no cure!

anon985952

You are missing a lot of key information. A high success rate with surgery is false; especially if you have other conditions in conjunction with or that caused your SMAS. The majority of people deal with gastroparesis and severe acid reflux even after surgery so, yes, surgery may have been successful in correcting the problem, but it doesn't end there.

I no longer live in pain but I still have days where I can't eat and I am reduced to liquids all day. Do you know what it's like to be so hungry and you want to eat but you can't? No. I'm sure you don't. Bloating and nausea usually never go away after surgery and sometimes vomiting doesn't either. I recommend connecting with other people who actually have this condition and getting information from them so you can more accurately describe this condition.

anon924655

@anon350058: Which form of SMAS do you have? A relative of mine was diagnosed a year ago with congenital chronic SMAS.

anon350058

Fully recovering after six months is a bunch of bull crap! I've had four major abdominal surgeries since 2003 for SMAS. I'm 6'2" and 135 pounds fully clothed. I still have two separate feeding tubes: one directly to my stomach and a catheter that goes to my lower intestine for feeding. It's complete misery and undiagnosed many times.

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