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Case Reports
. 2005 Oct;20(10):C3-4.
doi: 10.1111/j.1525-1497.2005.0201_2.x.

Superior mesenteric artery (Wilkie's) syndrome as a result of cardiac cachexia

Archana Roy  1 , Justin J Gisel, Vivek Roy, Ernest P Bouras
Affiliations
Case Reports

Superior mesenteric artery (Wilkie's) syndrome as a result of cardiac cachexia

Archana Roy et al. J Gen Intern Med. 2005 Oct.

Abstract

Superior mesenteric artery (SMA) syndrome is a rare acquired disorder in which acute angulation of SMA causes compression of the third part of the duodenum between the SMA and the aorta, leading to obstruction. Loss of fatty tissue as a result of a variety of debilitating conditions is believed to be the etiologic factor causing the acute angulation. We report a case of an 86-year-old man with prolonged congestive heart failure and aortic stenosis in which SMA syndrome developed as a result of cardiac cachexia. Because of poor functional status and comorbidities, he was not a suitable candidate for decompressive surgery. Conservative treatment using a gastrostomy tube with jejunal extension led to improvement in nutritional status and resolution of symptoms.

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Figures

FIGURE 1
FIGURE 1
Noncontrast computerized tomography scan of the abdomen showing dilated stomach and proximal duodenum. Compressed third part of the duodenum is seen between the calcified superior mesenteric artery and aorta. D, duodenum; Ao, aorta; S, stomach; SMA, superior mesenteric artery.
FIGURE 2
FIGURE 2
Radiological evaluation of the upper gastrointestinal tract showing compression of the third part of the duodenum (←) and dilated proximal duodenum. D, duodenum.
See this image and copyright information in PMC

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