Superior mesenteric artery syndrome – diagnostic difficulties

• Autorzy: Adamczyk M. , Romanowski M. , Medrek-Socha M. , Stec-Michalska K.

Warianty tytułu

PL

Zespół tętnicy krezkowej górnej – trudności diagnostyczne

• Języki publikacji: EN

Abstrakty

EN

Background. Superior mesenteric artery syndrome (SMAS) is a rare disease caused by the acute angle of branching of the superior mesenteric artery from the aorta. Material and methods. There were 63 patients (56 women and 7 men) with low body weight, who reported recurrent persistent abdominal pain, nausea, post-prandial vomiting, significant weight loss. All of them had abdominal ultrasonography performed with measurement of the angle of branching of SMA from the aorta. CBC, total bilirubin, AST, ALT, GT, ALP, amylase, lipase, albumins, iron, sodium, potassium, GFR, lipid profile, TSH, urinalysis were ordered. Additionally, esophagogastroduodenoscopy with Hp. test and esophageal impedance measurement in correlation with the reported ailments was performed. Results. Acid reflux impedance was diagnosed in 10 patients. There were >55 acid reflux episodes per day and a positive reflux sign (SI) for heartburn and nausea. Abnormal impedance recording of acid reflux was diagnosed in 17 patients. They had >21 episodes of non-acid reflux per day. Positive reflux sign (SI) was not confirmed for any non-acid reflux-related symptoms. Conclusions. It is justified to perform impedance pH monitoring in this group of patients as it allows to modify the therapy. The most important dietary recommendations are weight gain and understanding the cause of the disease.

PL

Wprowadzenie. Zespół tętnicy krezkowej górnej (ZTKG) (SMAS – ang. superior mesenteric artery syndrome) jest rzadko rozpoznawaną chorobą, a jej przyczyną jest ostry kąt odejścia tętnicy krezkowej górnej od aorty. Materiał i metody. Wyłoniono 63 pacjentów (56 kobiet i 7 mężczyzn) z niską masą ciała, którzy zgłaszali nawracające uporczywe dolegliwości bólowe w nadbrzuszu, nudności, poposiłkowe wymioty, istotną utratę masy ciała. Wszystkim wykonano ultrasonografię jamy brzusznej z pomiarem kąta odejścia TKG od aorty. Następnie oznaczono morfologię krwi, stężenie bilirubiny całkowitej, AST, ALT, GT, ALP, amylazy, lipazy, albuminy, żelazo, sód, potas, GFR, lipidogram oraz TSH, badanie ogólne moczu oraz wykonano gastrofiberoskopię z testem Hp. i pomiar impedancji przełykowej w korelacji ze zgłaszanymi dolegliwościami. Wyniki. Nieprawidłowy zapis impedancji w zakresie refluksu kwaśnego rozpoznano u 10 pacjentów. Zarejestrowano >55 epizodów refluksu kwaśnego na dobę oraz dodatni objaw refluksowy (SI) dla zgagi oraz uczucia nudności/mdłości. Nieprawidłowy zapis impedancji w zakresie refluksu niekwaśnego rozpoznano u 17 pacjentów. Obserwowano u nich >21 epizodów refluksu niekwaśnego na dobę. Dla żadnego objawu związanego z refluksem niekwaśnym nie potwierdzono dodatniego objawu refluksowego (SI). Wnioski. Uzasadnione jest wykonanie impendancji w tej grupie chorych gdyż pozwala na zmodyfikowanie terapii. Najważniejsze zalecenia dietetyczne to przyrost masy ciała i zrozumienie przyczyny choroby.

Słowa kluczowe

EN

superior mesenteric artery syndrome; laboratory test; diagnostic difficulty; esophageal impedance measurement; human disease

• Wydawca: -
• Czasopismo: Health Problems of Civilization
• Rocznik: 2019
• Tom: 13
• Numer: 4
• Opis fizyczny: p.296-306,ref.

Twórcy

autor

Adamczyk M.

• Department of Gastroenterology, Medical University of Lodz, Plac Hallera 1, 90-647 Lodz, Poland

autor

Romanowski M.

• Department of Gastroenterology, Medical University of Lodz, Plac Hallera 1, 90-647 Lodz, Poland

autor

Medrek-Socha M.

• Department of Clinical Nutrition and Gastroenterology Diagnostics, Medical University of Lodz, Lodz, Poland

autor

Stec-Michalska K.

• Department of Gastroenterology, Medical University of Lodz, Plac Hallera 1, 90-647 Lodz, Poland

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Identyfikatory

DOI

10.5114/hpc.2019.81333