Superior Mesenteric Artery (SMA) Syndrome
What Is Superior Mesenteric Artery (SMA) Syndrome?
Superior Mesenteric Artery (SMA) Syndrome is a rare digestive disorder in which the third portion of the duodenum becomes compressed between the abdominal aorta and the superior mesenteric artery. This compression can partially or completely block the normal passage of food through the small intestine, leading to chronic digestive symptoms and nutritional problems.
SMA syndrome is also known as Wilkie’s syndrome or cast syndrome. Because the condition is uncommon and symptoms may resemble other gastrointestinal disorders, diagnosis is often delayed. At Chicago Metabolic & Digestive Surgery Center, Dr. Jihad Kudsi provides advanced evaluation and minimally invasive surgical treatment for complex digestive disorders including SMA syndrome for patients throughout Chicago and surrounding suburban communities.
Symptoms of SMA Syndrome
Symptoms can range from mild to severe and may worsen after eating. Common symptoms include:
- Upper abdominal pain
- Nausea and vomiting
- Early fullness after meals
- Bloating
- Belching
- Unexplained weight loss
- Difficulty tolerating meals
- Indigestion
- Malnutrition
- Fatigue
Some patients notice that symptoms improve in certain body positions, such as lying on the left side or bringing the knees toward the chest.
Causes & Risk Factors
SMA syndrome commonly develops when the fatty tissue cushion between the superior mesenteric artery and the aorta becomes reduced, narrowing the angle between the vessels and compressing the duodenum.
Risk factors may include:
- Rapid weight loss
- Eating disorders
- Severe illness
- Trauma or burns
- Prolonged bed rest
- Prior abdominal or spinal surgery
- Low body weight
- Congenital anatomical variations
In some patients, the condition may occur after bariatric surgery or significant medical illness associated with rapid weight reduction.
Diagnosis of SMA Syndrome
Because SMA syndrome can mimic other digestive conditions, accurate diagnosis is essential.
Diagnostic evaluation may include:
- CT scan
- Upper GI series or barium swallow study
- Upper endoscopy
- Doppler ultrasound
- Laboratory testing
- Nutritional evaluation
CT imaging is commonly used to confirm narrowing of the aortomesenteric angle and compression of the duodenum.
Treatment Options for SMA Syndrome
Treatment depends on symptom severity, nutritional status, and the degree of intestinal obstruction.
Conservative & Nutritional Management
Initial treatment may focus on improving nutrition and restoring healthy body weight to rebuild the protective fat pad surrounding the superior mesenteric artery.
Conservative treatment may include:
- Nutritional support
- Small frequent meals
- Hydration
- Electrolyte correction
- Temporary feeding support
- Positional therapy
Some patients experience improvement with non-surgical treatment alone.
Minimally Invasive Surgical Treatment
When symptoms persist or conservative treatment is unsuccessful, surgery may be recommended.
Dr. Jihad Kudsi specializes in advanced minimally invasive and robotic digestive surgery for complex foregut and intestinal disorders. Surgical treatment aims to bypass or relieve the intestinal compression causing obstruction.
Laparoscopic Duodenojejunostomy
Laparoscopic duodenojejunostomy is considered one of the most effective surgical procedures for SMA syndrome. During the procedure, the compressed section of the duodenum is bypassed to allow food to move normally through the digestive tract.
Benefits of minimally invasive surgery may include:
- Smaller incisions
- Reduced postoperative discomfort
- Faster recovery
- Shorter hospital stay
- Improved digestive function
- Reduced scarring
Robotic-assisted surgical techniques may also provide enhanced visualization and surgical precision in complex digestive procedures.
Complications of Untreated SMA Syndrome
Without treatment, SMA syndrome may lead to:
- Severe malnutrition
- Dehydration
- Electrolyte imbalance
- Chronic vomiting
- Weight loss
- Intestinal obstruction
- Reduced quality of life
Early diagnosis and treatment may help prevent serious complications and improve long-term digestive health.
Expert Foregut & Digestive Surgical Care
Chicago Metabolic & Digestive Surgery Center is led by Dr. Jihad Kudsi, a nationally recognized surgeon specializing in minimally invasive, robotic, bariatric, foregut, and complex digestive surgery. Dr. Kudsi provides personalized treatment plans using advanced surgical techniques designed to improve patient outcomes and long-term quality of life.
The practice offers comprehensive care for patients throughout Chicago, Lombard, Glen Ellyn, and surrounding communities.
Schedule a Consultation
If you are experiencing chronic abdominal pain, nausea, vomiting, unexplained weight loss, or symptoms of SMA syndrome, contact Chicago Metabolic & Digestive Surgery Center to schedule a consultation and learn more about available treatment options.
For in-depth information please visit Dr. Kudsi’s website: Superior Mesenteric Artery (SMA) Syndrome
