Ultrasound imaging in diagnosis of superior mesenteric artery syndrome


Sergio Neri, Medicina Interna, Policlinico Ed. 29, I piano, Via S. Sofia, 95123 Catania, Italy.
(fax: 0039 095 3782908; e-mail: sergio.neri4@tin.it).


Objectives.  We screened a cohort of subjects affected by various degree of dyspepsia to reveal if they presented a reduction of the aorto-mesenteric angle and to diagnose suspected cases of superior mesenteric artery (SMA) syndrome.

Design.  Controlled, prospective, study.

Setting. Subjects were studied as outpatients.

Subjects.  The study investigated a total of 3622 subjects referred to our department by their general practitioners for dyspepsia and/or abdominal pain.

Interventions.  Abdominal ultrasonography with power colour Doppler, gastroduodenoscopy, hypotonic duodenography, contrast-enhanced spiral computerized tomography were performed.

Main outcome measurement and results.  Color Doppler revealed a significant reduction of the SMA angle in 29 of 950 subjects; gastroscopy showed duodenal compressive pulsation in 14 of 29 patients and X-ray revealed compression of the third segment of the duodenum in 28 of 29 patients. CT confirmed the presence of a reduced angle and various degrees of duodenal compression in all patients. Ultrasonography and CT examinations gave overlapping results (P > 0.05) in diagnosing pathological aorto-mesenteric angle.

Conclusion.  The authors believe that the incidence of reduced aorto-mesenteric angle and SMA syndrome might be underrated.

Ultrasound power colour Doppler imaging is useful in epidemiological screening of reduced aorto-mesenteric angle to diagnose suspected cases of SMA syndrome.