Cihan AYDİN, Kağan GÖKÇE, Emrah DOĞAN, Burak Can DEPBOYLU

Duodenal Obstrüksiyonun Nadir Bir Nedeni: Süperior Mezenterik Arter Sendromu

Süperior mezenterik arter sendromu (SMAS), sıklıkla hızlı kilo kaybeden hastalarda gelişen, üst gastrointestital sistem obstrüksiyonunun nadir sebeplerindendir. En sık semptomları, postprandial epigastrik ağrı, dolgunluk ve safralı kusmadır. Semptomlar, duodenumun üçüncü kısmının dar açılı süperior mezenterik arter (SMA) ile arka yapılar arasındaki sıkışması sonucu ortaya çıkar. Sonunda cerrahi tedavi gerekir. 29 yaşında kadın hasta, 2 yıllık epigastrik bölgede belirsiz karın ağrısı, postprandial rahatsızlık ve tekrarlayan kusma hikayesi ile başvurdu. SMAS; bilgisayarlı tomografi (BT) taraması ve floroskopi kullanılarak teşhis edildi. Hastaya loop duodenojejunostomi operasyonu uygulandı. Postoperatif takiplerde sorun yaşanmayan hasta uygun diyet programı ile taburcu edildi.

Anahtar Kelimeler:

Duodenojejunostomi, Süperior Mezenterik Arter Sendromu, Wilkie’s Sendromu

A Rare Cause of Duodenal Obstruction: Superior Mesenteric Artery Syndrome

The superior mesenteric artery syndrome (SMAS) is a rare cause of upper gastrointestinal system obstruction, most frequently occurring in patients who have had rapid weight loss. Most frequent symptoms are postprandial epigastric pain, fullness and bilious vomiting. Symptoms are caused by compression of the third portion of duodenum between the posterior structures and the narrow-angled superior mesenteric artery (SMA). Eventually surgical treatment is required. A 29-year-old woman presented with a 2-year history of abdominal pain mainly at the epigastric region, postprandial discomfort and repeated vomiting. The SMAS was diagnosed by using computed tomography (CT) scan and fluoroscopy. Loop duodenojejunostomy operation was performed. The patient who had no problem in postoperative follow-up, was discharged with a proper diet program.

Keywords:

Duodenojejunostomy, Superior Mesenteric Arterysyndrome, Wilkie's Syndrome,

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