肠系膜上动脉综合征 (2)讲稿.ppt
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1、关于肠系膜上动脉综合征(2)第一页,讲稿共三十四页哦第二页,讲稿共三十四页哦第三页,讲稿共三十四页哦第四页,讲稿共三十四页哦Superior mesenteric artery syndrome 第五页,讲稿共三十四页哦 superior mesenteric artery syndrome is a very rare,life-threatening gastrovascular disorder characterized by a compression of the third portion of the duodenum by the superior mesenteric ar
2、tery.第六页,讲稿共三十四页哦 SMA syndrome was first described in 1861 by Carl Freiherr von Rokitansky in victims at autopsy,but remained pathologically undefined until 1927 when Wilkie published the first comprehensive series of 75 patients.With only about 500 reported cases in the history of English-language
3、medical literature,SMA syndrome is estimated to have a mortality rate of 1 in 3.第七页,讲稿共三十四页哦 SMA syndrome is also known as Wilkies syndrome,cast syndrome,mesenteric root syndrome,chronic duodenal ileus It is distinct from Nutcracker syndrome,which is the entrapment of the left renal vein between the
4、 AA and the SMA.第八页,讲稿共三十四页哦causes The syndrome is typically caused by an angle of 6-25between the AA and the SMA,in comparison to the normal range of 38-56due to a lack of retroperitoneal and visceral fat.In addition,the aorto-mesenteric distance is 2-8 millimeters,as opposed to the typical 10-20.第
5、九页,讲稿共三十四页哦 Retroperitoneal fat and lymphatic tissue normally serve as a cushion for the duodenum,protecting it from compression by the SMA.SMA syndrome is thus triggered by any condition involving an insubstantial cushion and narrow mesenteric angle.SMA Syndrome can present in two forms:chronic/con
6、genital or acute/induced.第十页,讲稿共三十四页哦第十一页,讲稿共三十四页哦Risk anatomic factors such as:very thin or lanky body build,an unusually high insertion of the duodenum at the ligament of Treitz,a particularly low origin of the SMA.第十二页,讲稿共三十四页哦Predisposition easily aggravated such aspoor motility of the digestive
7、 tractretroperitional tumorscachexiaexaggerated lumbar lordosisvisceroptosisabdominal wall laxityperitoneal adhesionsabdominal trauma第十三页,讲稿共三十四页哦rapid linear adolescent growth spurt,weight lossstarvationcatabolic states(cancer and burns).第十四页,讲稿共三十四页哦Symptomsearly satietynauseabilious vomitingextre
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