![]() ![]() The cycle of nausea and vomiting leads to inadequate food intake with results in weight loss and thus, aggravation of the syndrome. In the chronic state, non-specific and intermittent postprandial pain, nausea, vomiting and weight loss often prevail. In the acute phase, severe intestinal obstruction leads to life-threatening dilatation of the stomach. Pain can be intermittent or chronic depending on the severity of obstruction. Symptoms are alleviated with the release of the angle which can be demonstrated in a prone, knee to the chest or left lateral decubitus position. Other symptoms include abdominal distension, weight loss, early satiety and postprandial epigastric pain which worsens in the supine position. The most common symptoms reported are an epigastric pain, nausea, and vomiting. Patients typically present with either an acute or gradual course of symptoms. Other risk factors include surgical correction of scoliosis, congenitally short or hypertrophic ligament of Treitz, peritoneal adhesions, duodenal malrotation, Ladd's bands, abdominal aortic aneurysm, lumbar hyperlordosis, and mesenteric root neoplasm.ĭiagnosis is difficult to make clinically as the signs and symptoms are usually vague and non-specific. SMA syndrome is associated with significant weight loss including situations of hypermetabolism (trauma and burns) dietary conditions (anorexia nervosa and malabsorptive diseases) and cachexia causing conditions (AIDS, cancer, paraplegia). Decreases in the aortomesenteric angle can be either congenital or acquired. A normal aortomesenteric angle is 38 to 65 degrees however, decreasing the angle less than 25 degrees will decrease the distance to less than 10 mm and cause compression to the third part of the duodenum. The fat pad cushion functions to hold the SMA off the spine and protect it from duodenal compression. Duodenal compression is usually due to the loss of the intervening mesenteric fat pad between the aorta and SMA, which in turn, results in a narrower angle between the vessels.
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