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Superior mesenteric artery(SMA)

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https://www.readbyqxmd.com/read/29242494/incidental-anatomic-finding-of-celiacomesenteric-trunk-associated-with-nutcracker-phenomenon-or-compression-of-the-left-renal-vein
#1
Joshua Peterson, Anthony N Hage, Stephan Diljak, Benjamin D Long, Daniel P Marcusa, John M Stribley, David W Brzezinski, Jonathan Eliason
BACKGROUND Celiacomesenteric trunk (CMT) is a very rare anatomic finding in which the celiac artery and the superior mesenteric artery (SMA) originate from the abdominal aorta through a common trunk. Clinical associations with CMT include arterial aneurysm, thrombosis, and celiac artery compression. However, an association between CMT and abdominal venous congestion caused by left renal vein compression, or 'nutcracker phenomenon,' has not been previously reported. CASE REPORT A 91-year-old woman, who died from a cerebrovascular accident (CVA), underwent a cadaveric examination at our medical school...
December 15, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29234730/spontaneous-superior-mesenteric-artery-branch-pseudoaneurysm-a-rare-case-report
#2
Mina Guirgis, Jema Hua Xu, Alar Kaard, Bibombe P Mwipatayi
Background: Visceral arterial pseudoaneurysms (VAPAs) are rare vascular entities with serious consequences. Traditionally, they are associated with trauma, infection, and inflammatory disease, or they can arise as a post-operative complication. Report: An 87 year old man presented with abdominal pain and was found to have a spontaneous VAPA on a computed tomography angiogram. Serial imaging 4 months previously had demonstrated no aneurysm. Between scans, warfarin was changed to apixaban for aortic valve replacement, but he had no other changes to any other medications...
2017: EJVES Short Reports
https://www.readbyqxmd.com/read/29205361/vascular-anatomy-of-the-jejunal-mesentery-and-complications-associated-with-division-of-the-first-jejunal-venous-trunk-during-pancreaticoduodenectomy
#3
Yuta Kobayashi, Yoshihiro Sakamoto, Junichi Arita, Nobuhisa Akamatsu, Junichi Kaneko, Kiyoshi Hasegawa, Norihiro Kokudo
BACKGROUND: Little is known about the anatomy of the jejunal veins (JVs) flowing into the superior mesenteric vein (SMV), and whether they can be safely divided during pancreaticoduodenectomy. METHODS: Computed tomography was used to review the jejunal branches off the superior mesenteric artery (SMA) and into the SMV in 123 consecutive patients. The common trunk of the JVs (jejunal venous trunk, JVT) was classified as ventral or dorsal to the SMA. RESULTS: The first JVT involved multiple JVs in 108 (87...
December 4, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29197396/new-laparoscopic-procedure-for-left-sided-pancreatic-cancer-artery-first-approach-laparoscopic-ramps-using-3d-technique
#4
Michihiro Yamamoto, Masazumi Zaima, Hidekazu Yamamoto, Hideki Harada, Junichiro Kawamura, Masahiro Yamada, Tekefumi Yazawa, Junya Kawasoe
BACKGROUND: For left-sided pancreatic ductal adenocarcinoma (PDAC), radical antegrade modular pancreatosplenectomy (RAMPS) is a reasonable surgical approach for tumor-free margin resection and systemic lymph node clearance. In pancreaticoduodenectomy for PDAC, the superior mesenteric artery (SMA)-first approach (or the "artery-first approach") has become the standard procedure. With improvements in laparoscopic instruments and techniques, some surgeons attempted to apply laparoscopic RAMPS (L-RAMPS) for carefully selected patients with left-sided PDAC...
December 2, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29183305/hemodynamic-benefits-of-celiac-artery-release-for-ruptured-right-gastric-artery-aneurysm-associated-with-median-arcuate-ligament-syndrome-a-case-report
#5
Tetsuro Toriumi, Takuro Shirasu, Atsushi Akai, Yuichi Ohashi, Takatoshi Furuya, Yukihiro Nomura
BACKGROUND: It has been reported that median arcuate ligament syndrome is closely associated with gastric or pancreaticoduodenal artery aneurysms. Hemodynamic state plays an important role in the formation of the aneurysms. These aneurysms are treated with open resection or endovascular exclusion. However, whether revascularization of the celiac artery can prevent the aneurysm formation is unknown. This report indicated a possibility that prophylactic revascularization for celiac artery stenosis resulted in decreased shear stress on the collaterals, which may otherwise be susceptible to new aneurysms...
November 28, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29168288/robotic-strong-s-procedure-for-the-treatment-of-superior-mesenteric-artery-syndrome-description-of-surgical-technique-on-occasion-of-the-first-reported-case-in-the-literature
#6
Harilaos Konstantinidis, Christos Charisis, Panagiotis Kottos
BACKROUND: Superior Mesenteric Artery Syndrome (SMAS) is a rare disorder caused by compression of the third portion of the duodenum by the SMA. Once a conservative approach fails, usual surgical strategies include Duodenojejunostomy and Strong's procedure. The latter avoids potential anastomotic risks and complications. Robotic Strong's procedure (RSP) combines both the benefits of a minimal invasive approach and also enchased robotic accuracy and efficacy. METHODS: For a young girl who was unsuccessfully treated conservatively, the paper describes the RSP surgical technique...
November 23, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/29162665/the-beneficial-effects-of-curcumin-in-cirrhotic-rats-with-portal-hypertension
#7
Shao-Jung Hsu, Jing-Yi Lee, Te-Yueh Lin, Yu-Hsin Hsieh, Hui-Chun Huang, Fa-Yauh Lee, Han-Chieh Lin, Ming-Chih Hou, Shou-Dong Lee
In liver cirrhosis with portal hypertension, the uneven distribution of vasoactive substances leads to increased intrahepatic vascular resistance and splanchnic vasodilatation. Angiogenesis also induces increased portal inflow and portosystemic collaterals. The collaterals may induce lethal complications such as gastroesophageal variceal hemorrhage, but the therapeutic effect of vasoconstrictors is still suboptimal due to poor collateral vasoresponsivenss. Curcumin has aroused much attention for its anti-fibrosis, vasoactive and anti-angiogenesis actions...
November 21, 2017: Bioscience Reports
https://www.readbyqxmd.com/read/29161795/superior-mesenteric-artery-syndrome-combined-with-renal-nutcracker-syndrome-in-a-young-male-a-case-report
#8
Myung Jin Oh
Superior mesenteric artery (SMA) syndrome is one of the rare causes of small bowel obstruction. It develops following a marked decrease in the angle between SMA and the abdominal aorta due to weight loss, anatomical anomalies, or following surgeries. Nutcracker syndrome in the left renal vein may also occur following a decrease in the aortomesenteric angle. Though SMA syndrome and renal nutcracker syndrome share the same pathogenesis, concurrent development has rarely been reported. Herein, we report a 23-year-old healthy male diagnosed with SMA syndrome and renal nutcracker syndrome due to severe weight reduction...
November 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29157477/spontaneous-dissection-of-superior-mesenteric-artery-long-term-outcome-of-stent-placement
#9
Junghoon Kim, Chang Jin Yoon, Nakjong Seong, Hyukjoon Lee, Young-Joo Kim
Stent placement was performed in 10 patients with symptomatic spontaneous dissection of the superior mesenteric artery (SMA). A stent was placed as first-line treatment in 7 patients and as second-line treatment in 3 patients in whom conservative treatment had failed. Abdominal pain completely resolved within 2 days after stent placement, and follow-up (median 53 months; range, 11-99 months) CT angiography revealed complete obliteration of the false lumen and good stent patency in 9 patients. One patient showed asymptomatic stent occlusion at 99-month follow-up...
December 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29151701/clinical-outcomes-of-transcatheter-selective-superior-mesenteric-artery-urokinase-infusion-therapy-vs-transjugular-intrahepatic-portosystemic-shunt-in-patients-with-cirrhosis-and-acute-portal-vein-thrombosis
#10
Ting-Ting Jiang, Xiao-Ping Luo, Jian-Ming Sun, Jian Gao
AIM: To compare the outcomes of transcatheter superior mesenteric artery (SMA) urokinase infusion and transjugular intrahepatic portosystemic shunt (TIPS) for acute portal vein thrombosis (PVT) in cirrhosis. METHODS: From January 2013 to December 2014, patients with liver cirrhosis and acute symptomatic PVT who met the inclusion criteria were randomly assigned to either an SMA group or a TIPS group. The two groups accepted transcatheter selective SMA urokinase infusion therapy and TIPS, respectively...
November 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29147150/localized-aortic-root-dissection-with-a-superior-mesenteric-artery-aneurysm
#11
Akihiko Ikeda, Tomomi Nakajima, Yuji Hiramatsu, Tomoaki Jikuya
In this study, the case of a 46-year-old female patient with localized aortic root dissection and a superior mesenteric artery (SMA) aneurysm is described. Computed tomographic angiography could not clearly delineate an intimal flap in the aortic root, but it detected SMA aneurysm, which implied the presence of a vulnerability of the aortic wall. Finally, transesophageal echocardiography (TEE) evidently showed the intimal flap localized in the aortic root. The present case suggests that TEE is of paramount importance for detecting localized aortic root dissection...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29146096/ten-year-review-of-isolated-spontaneous-mesenteric-arterial-dissections
#12
Courtney E Morgan, Neel A Mansukhani, Mark K Eskandari, Heron E Rodriguez
OBJECTIVE: Isolated spontaneous dissection of the superior mesenteric artery (SMA) and celiac artery (CA) remains a rare condition; however, it has been increasingly noted incidentally on diagnostic imaging. The purpose of this study was to examine the natural history and outcomes of patients presenting with isolated spontaneous mesenteric artery dissection (SMAD). We hypothesized that most SMADs can be treated nonoperatively. METHODS: This was a single-center retrospective review of patients presenting with the diagnosis of SMAD between 2006 and 2016...
November 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29145276/endovascular-stenting-of-spontaneous-isolated-dissection-of-the-superior-mesenteric-artery-a-case-report-and-literature-review
#13
Dong-Na Gao, Qing-Hui Qi, Ping Gong
RATIONALE: Spontaneous isolated dissection of the superior mesenteric artery (SID-SMA) is a rare arterial disease that is difficult to differentiate from other diseases because of lack of specific clinical manifestation and for which there is no available optimal management strategy. PATIENT CONCERNS: A 58-year-old male patient visited our emergency room with sudden onset of moderate-severe epigastric abdominal pain of uncertain cause. DIAGNOSES: Computed tomography scanning showed a characteristic "double lumen sign" of the superior mesenteric artery, and further computed tomography angiography findings revealed a dissected segment of the superior mesenteric artery...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29121843/bifurcated-stent-technique-a-viable-option-for-treatment-of-patients-with-unusual-anatomy-presenting-with-combined-chronic-mesenteric-ischemia-and-diffuse-ischemic-gastric-ulcers
#14
Jesse Manunga
Treatment of chronic mesenteric ischemia has evolved over the last two decades. Endovascular therapy is now the treatment of choice for patients with lesions amenable to such an approach. Open revascularization remains the standard of care but is frequently being reserved for lesions containing intraluminal thrombus or severe calcification. In most cases, celiac axis (CA) stenting is not needed since revascularization of the superior mesenteric artery (SMA) alone results in symptomatic resolution. This report describes a case of a patient with chronic mesenteric ischemia and diffuse gastric ulcers found to have a common origin of the SMA and CA that was treated endovascularly using a bifurcated stent technique...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29115394/high-glucose-upregulates-endothelin-type-b-receptors-in-vascular-smooth-muscle-cells-via-the-downregulation-of-sirt1
#15
Yan Lin, Yan Zhao, Enqi Liu
Silent information regulator family protein 1 (Sirt1) has recently gained attention for its protective effects against diabetic and cardiovascular diseases (CVDs). Vascular smooth muscle endothelin type B (ETB) receptors are involved in the pathogenesis of CVDs and diabetes. The aim of present study was to explore whether Sirt1 is involved in high glucose (HG)-mediated regulation of ETB receptors in rat superior mesenteric arteries (SMA). The rat SMA segments were cultured in the presence and absence of HG with or without the activator of Sirt1 and specific inhibitor for the extracellular signal-regulated protein kinase 1/2 (ERK1/2) for 24 h...
November 7, 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/29104203/-acute-type-b-aortic-dissection-complicated-with-malperfusion-of-celiac-artery-alone-report-of-a-case
#16
Motohiro Koyama, Kae Ito, Keishi Ueyama
Malperfusion of the superior mesenteric artery(SMA) in acute type B aortic dissection is potentially fatal. Revascularization should therefore be aggressively considered in a proactive way. However, this is not the case with the celiac artery malperfusion. We present a case of malperfusion of isolated malperfusion of the celiac artery due to acute type B aortic dissection. Although the collateral blood flow from the SMA via the pancreatic arcade was identified, ischemic gastric ulcer and pancreatitis developed later on...
November 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29093592/-persistent-abdominal-pain-caused-by-superior-mesenteric-artery-and-celiac-trunk-dissection-that-does-not-respond-to-conservative-treatment
#17
Óscar Talledo, Lourdes Torres, Horacio Valenzuela, Alejandro Calle, María A Mena, Óscar De La Peña, Diego Lizarzaburu
We report the case of a 32 year old male with recurrent colic abdominal pain due to superior mesenteric artery (SMA) and celiac trunk dissection, which resolved after placing 3 stents in SMA. The patient presented atypical clinical signs and symptoms, which made the diagnosis difficult. Clinical presentation, diagnostic methods and treatment options are discussed. We started with conservative management with pain medication, anticoagulation, antihypertensive drugs and image control, but on the seventh day, after restarting oral ingestion, he presented with abdominal angina, after which we proceeded to endovascular treatment with successful results and with an uneventfully 2 year follow up...
July 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/29055874/sma-like-syndrome-with-variant-mesenteric-venous-anatomy
#18
James Shin, Paul J Shin, Roger J Bartolotta
Superior mesenteric artery (SMA) syndrome refers to the constellation of symptoms that are associated with intermittent obstruction of the duodenum due to vascular compression. We present a case of SMA-like syndrome related to variant mesenteric venous drainage in the setting of normal aortomesenteric angle (AMA) and borderline reduced aortomesenteric distance (AMD).
April 6, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/29051395/role-of-computer-tomography-and-endoscopic-ultrasonography-in-assessing-portal-and-superior-mesenteric-vessels-invasion-in-cephalo-pancreatic-adenocarcinoma
#19
Raluca Bodea, Andrada Seicean, Tudor Vasile, Tudor Calinici, Irina Ciuca, Nadim Al Hajjar, Cornel Iancu, Constantin Iordache
AIM: The aim of this study is to evaluate the information given by contrast-enhanced computer tomography (CECT) and ultrasound endoscopy (EUS) regarding vascular involvement of cephalo-pancreatic cancer, data compared with intraoperative findings. MATERIAL AND METHODS: We choose to analyze the most often interested vessels by tumor development, such as superior mesenteric artery (SMA), superior mesenteric vein (SMV) and portal vein (PV). The patients included in the study (n=425) had a cephalo-pancreatic tumor diagnosed in our Institute and a positive histology for pancreatic adenocarcinoma...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29049228/the-efficiency-of-sonography-in-diagnosing-volvulus-in-neonates-with-suspected-intestinal-malrotation
#20
Wenhua Zhang, Hongjun Sun, Fangqiong Luo
This study is to prospectively evaluate the efficiency of sonography for volvulus diagnosis in neonates with clinically suspected intestinal malrotation.A total of 83 patients with suspected intestinal malrotation who underwent detailed abdominal sonography and upper gastrointestinal contrast study were included. Malrotation was characterized by inversion of the superior mesenteric artery (SMA) and superior mesenteric vein (SMV) in sonographic examination. The "whirlpool sign" of Color Doppler Sonography was recognized as a characteristic for malrotation with volvulus...
October 2017: Medicine (Baltimore)
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