SMAS: a Prospective Study in a Single Institution
SMAS: a Prospective Study in a Single Institution
Superior Mesenteric Artery Syndrome (SMAS) is a rare cause of duodenal obstruction, that
 should be suspected in cases of chronic, refractory upper digestive symptoms. Between 2008
 and 2016, 39 consecutive patients with chronic gastrointestinal symptoms and a diagnosis of
 SMAS were prospectively included in the study, in order to describe their demographic,
 clinical and outcome features. All patients underwent duodenojejunostomy.
Inclusion Criteria (at least 2 of the following):

 -  severe and frequent upper digestive symptoms (occurring at least once a week),
 associated to poor quality of life and refractory response to medical treatment;

 -  a condition of underweight (BMI <18.5 kg/m2) associated with difficulty eating;

 -  severe complications of SMAS (e.g. gastric perforation, acute pancreatitis, aspiration
 pneumonia);

 -  suggestive findings of SMAS at barium swallow;

 -  diagnostic aortomesenteric angle and distance at CT/MR angiography.

 Exclusion Criteria:

 -  inability to provide the informed consent;

 -  malignancies;

 -  bowel motility disorders;

 -  severe psychiatric illness;

 -  pregnancy;

 -  impossibility to perform the required diagnostic workup.