The Superior Mesenteric Artery: From Syndrome in the Young to Vascular Atherosclerosis in the Old
| Autor: | Thomas F. Whayne, Ana Karolina Víquez Beita |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Abdominal pain
medicine.medical_specialty Superior Mesenteric Artery Syndrome medicine.medical_treatment Ischemia 030204 cardiovascular system & hematology Coronary artery disease 03 medical and health sciences 0302 clinical medicine Mesenteric Artery Superior medicine.artery Angioplasty Internal medicine medicine Humans Superior mesenteric artery Pharmacology business.industry Age Factors Disease Management Hematology medicine.disease SMA Atherosclerosis medicine.anatomical_structure Duodenum Cardiology 030211 gastroenterology & hepatology medicine.symptom Cardiology and Cardiovascular Medicine business Superior mesenteric artery syndrome |
| Zdroj: | Cardiovascularhematological agents in medicinal chemistry. 17(2) |
| ISSN: | 1875-6182 |
| Popis: | This review is directed at increasing awareness of two diverse rare upper gastrointestinal problems that occur at opposite ends of the age spectrum and are difficult to diagnose and treat. The Superior Mesenteric Artery Syndrome (SMAS) likely involves a young patient, especially female, and is especially associated with rapid weight loss, resulting in relative strangulation of the duodenum by a narrowing of the angle between the Superior Mesenteric Artery (SMA) and the aorta. On the other hand, atherosclerosis of the SMA is associated most likely with postprandial upper intestinal ischemia and abdominal pain occurs in the elderly at high risk for cardiovascular (CV) disease.:Medical management of the SMAS in the young involves good alimentation and weight gain to overall increase the intestinal fat pad. Medical management of SMA atherosclerotic ischemia in the elderly is directed at marked lipid lowering with atherosclerotic plaque stabilization or even regression.:If needed, surgery for SMAS can be attempted laparoscopically with duodenojejunoscopy which is the most popular procedure but there are also more conservative possibilities that avoid division of the duodenum. In addition, sometimes direct vision is needed to successfully operate on SMAS. If surgery is needed for SMA atherosclerotic ischemia, it is usually attempted endoscopically with angioplasty and stent placement.:Most important, in the case of these two rare clinical entities, is that the clinician have a suspicion of their presence when indicated so that the young or old patient can be spared unnecessary suffering and return to good health in a timely fashion. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|