Superior Mesenteric Artery Syndrome w/scoliosis

[countrymom]

Has anyone ever heard of a diagnosis of Superior Mesenteric Artery Syndrome (SMA) in someone who has a diagnosis of scoliosis (80 degree curve)? My daughter is 24, also has a diagnosis of severe spastic quad cerebral palsy. Info. I have found has indicated this can be a complication post operatively. My daughter has not had corrective surgery due to other health risks. Symptoms are frequent vomiting due to compression of duodenum between the aorta and superior mesenteric artery; possibly caused by severe spine deformity and low weight. Any info. would be very appreciated. Thanks!

[LindaRacine]

Hi...

In case you haven't done a Google search:

http://www.google.com/search?biw=1035&hl=en&q=%22Superior+Mesenteric+Artery+Syndrome%22+scolio sis&btnG=Google+Search

Regards,
Linda

[countrymom]

Hi, I did do a search. I found information on description of SMA syndrome, but not possible treatment options. I am interested in what people may have tried to help relieve symptoms. Thanks for the suggestion.

[LindaRacine]

Hi...

Wanted to be sure you'd seen this:

Medical Care: Reversing or removing the precipitating factor is usually successful in a patient with acute SMA syndrome. Conservative initial treatment is recommended in all patients with SMA syndrome; this includes adequate nutrition, GI decompression, and proper positioning of the patient after eating (ie, left lateral decubitus, prone, or knee-to-chest position). Enteral feeding through a tube passed distal to the obstruction or total parenteral nutrition can be an effective adjunct in treatment of patients with rapid severe weight loss. Metoclopramide treatment may be beneficial. Review of the orthopedic literature reveals that the success rate is 100% with medical management only in cases with an acute presentation of SMA syndrome.

Surgical Care: Surgical intervention is indicated when conservative measures are ineffective, particularly in patients with a long history of progressive weight loss, pronounced duodenal dilatation with stasis, and complicating peptic ulcer disease. Duodenojejunostomy is the most frequently used procedure, and it is successful in about 90% of cases. The use of laparoscopic surgery that involves lysis of the ligament of Treitz and mobilization of the duodenum has been reported.

Consultations:

* Pediatric gastroenterologist

* Nutritionist

* Pediatric surgeon

Diet: Medical therapy usually begins with the initiation of intravenous fluids, with the frequent administration of small amounts of liquids. In some cases, nasogastric tube feedings with a standard liquid diet may be indicated.


Regards,
Linda

[countrymom]

Hi Linda, Thank you. I did not see this information. We did meet with a rehab Dr. & basically were told that it can occur in patients with scoliosis who have thin stature; and/or patients who experience rapid weight loss. We're going to try encouraging her to eat nutritional shakes to up her caloric intake and positional changes as well. Apparently this diagnosis is confirmed with an Upper GI and/or abdominal CT scan which we have scheduled. Thanks again. :)
Charlene