CRITERIA FOR ASSESSMENT OF SUPERIOR MESENTERIC ARTERY SYNDROME

Superior Mesenteric Artery Syndrome (SMAS) is a rare cause of upper
intestinal obstruction manifested by retching or vomiting. Thanks to the difficulties arising in its
diagnosis, it is usually done by elimination of other causes. We tried to report on the radiological
manifestation of this rare syndrome aiming to find reliable predictable signs in imaging.
Materials & Methods: The findings obtained from abdominal MDCT and barium meal of 50 adult
patients with clinical symptoms suspected for SMAS.
Result: Our study showed two radiographic signs for diagnosis of SMAS: which are dilatation of
descending duodenum because of D3 compression and decreased aorto-mesenteric angle. Multi-
Detector-Computerized-Tomography (MDCT) was preferable to obtain the exact angle range between
SMA and aorta. There was a significant correlation between D3 diameter and aorto-mesenteric angle
(p<0.01). 3 cases were diagnosed as SMAS, among 50 cases enrolled in this study. The mean angle
was 17±1 degree and the mean D3 diameter was 0.46±0.024 cm.
Conclusion: MDCT is preferable imaging modality compared to barium study where we can exclude
other simulating causes with different symptoms. It can provide the exact angle between SMA and
aorta which is a essential imaging sign for diagnosis