Resumen

OSEGUEDA DE RODRIGUEZ, Elvia Johanna; HERNANDEZ-VILLEGAS, Antonio Carlos; SERRALDE-ZUNIGA, Aurora Elizabeth  y  REYES-RAMIREZ, Ana Luz del Carmen. The two sides of superior mesenteric artery syndrome treatment:: conservative or surgical management?. Nutr. Hosp. [online]. 2017, vol.34, n.4, pp.997-1000. ISSN 1699-5198.  https://dx.doi.org/10.20960/nh.1006.

Introduction: Superior mesenteric artery syndrome (SMAS) is a rare condition characterized by vascular compression of the duodenum. There is controversy regarding the optimal treatment. Case report: In case 1, we describe the case of a 21-year-old woman (body mass index [BMI] 16.9 kg/m²) with high-level obstructive symptoms three months prior, with computed tomography scan (TC) showing a superior mesenteric artery aorta angle (SMAA) of 13^o and compression of the third portion of the duodenum (D3), for this reason a nasojejunal tube was placed for enteral feeding. In case 2, enteral nutrition was initiated for feeding a 17-year-old female with anorexia nervosa (BMI 8.3 kg/m²). She presented macrohematuria, vomiting, epigastralgia, abdominal distension and acute abdomen when oral feeding was reinitiated. TC reported a SMAA of 15^o, in addition to compression of the left renal vein (Nutcracker syndrome) and gastro duodenal expansion, surgical management was necessary. Discussion: Both cases had favorable evolution, being the nutritional support fundamental. SMAS should be suspected in all people with high-level obstructive symptoms and recent weight loss.

Palabras clave : Mesenteric clamp; Superior mesenteric artery syndrome; Obstructive symptoms; Nutritional support; Surgical treatment.

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