Pancreatic exocrine insufficiency in superior artery mesenteric syndrome – Wilkie syndrome: rationale and practical considerations on exocrine dysfunction after surgical attacks
Authors:
R. Petro 1; T. Malý 2; S. Kupková 3; K. Veselská 4; J. Schwarz 5; R. Pomahačová 5; M. Kreslová 5; A. Masopustová 5; M. Huml 5; J. Sýkora 5
Authors‘ workplace:
Ambulance pro dětskou gastroenterologii, Nemocnice Karviná
1; Chirurgická klinika FN, Lékařská fakulta Univerzity Palackého, Olomouc
2; Radiologické oddělení, Nemocnice Karviná-Ráj
3; Ordinace praktického lékaře pro děti a dorost, Petrovice u Karviné
4; Dětská klinika, Univerzita Karlova, Lékařská fakulta v Plzni, Fakultní nemocnice, Plzeň
5
Published in:
Čes-slov Pediat 2017; 72 (8): 478-488.
Category:
Case Report
Overview
Superior mesenteric artery (SMA) syndrome is an uncommon cause of upper bowel obstruction. SMA syndrome is linked to unspecific upper digestive symptomps. The main point of this research is the presence of exocrine pancreatic insufficiency (EPI) linked to SMA syndrome assessed by fecal elastase-1. EPI was proposed as the underlying pathogenesis, thus this group of children necessitates routine screening for pancreatic dysfunction.
There are several types of appropriate therapeutic options and the patophysiological aspects of the changes on EPI after surgical approaches were discussed. We suggest that SMA syndrome must be considerd as a new cause of exocrine pancreatic dysfunction.
Key words:
superior mesenteric artery syndrome, exocrine pancreatic dysfunction, fecal elastase-1, operation
Sources
1. Wilkie D. Chronic duodenal ileus. Am J Med Sci 1927; 173: 643–649.
2. Valdes A, Cárdenas A, Espinosa A, et al. Superior mesenteric artery syndrome. J Am Coll Surg 2005; 201: 808.
3. Rokitansky C. Handbuch der Pathologischen Anatomie. Vienna: Braumuller and Siedel, 1842.
4. Boráňová S, Žáčik M. Syndrom arteria mesenterialis superior. Pediatr praxi 2012; 13: 407–408.
5. Mihál V, Malý T, Heřmanová Z, Michálková K. Vzácná etiologie horní střevní obstrukce u dětí – syndrom arteria mesenterialis superior. Pediatr praxi 2014; 15: 371–373.
6. Zlámal Z. Několik poznámek chirurga k duodenální obstrukci u dětí. Pediatr praxi 2006; 6: 288–289.
7. Fargaš E, Skácel V. Syndrom kraniální mezenterické arterie. Acta Univ Palacki Olomuc Fac Med 1963; 32: 63–71.
8. Shiu JR, Chao HC, Luo CC, et al. Clinical and nutritional outcomes in children with idopathic superior mesenteric artery syndrome. J Pediatr Gastroenterol Nutr 2010; 51: 177–182.
9. Okugawa Y, Inoue M, Uchida K, et al. Superior mesenteric artery syndrome in an infant: case report and literature review. J Pediatr Surg 2007; 42: E5–E8.
10. Elbadawy MH. Chronic superior mesenteric artery syndrome in anorexia nervosa. Br J Psychiatry 1992; 160: 552–554.
11. Van Brussel JP, Dijkema WP, Adhin SK, Jonkers GJPM. Wilkie‘s syndrome, a rare cause of vomiting and weight loss: diagnosis and therapy. Neth J Med 1997; 51: 179–181.
12. Shapiro G, Green DW, Fatica NS, Boachie-Adjei O. Medical complications in scoliosis surgery. Curr Opin Pediatr 2001; 13: 36–41.
13. Pedoto MJ, O‘Dell MW, Thrun M, Hollifield D. Superior mesenteric artery syndrome in traumatic brain injury: two cases. Arch Phys Med Rehabil 1995; 76: 871–875.
14. Laffont I, Bensamil D, Rech C, et al. Late superior mesenteric artery syndrome in paraplegia: case report and review. Spinal Cord 2002; 40: 88–91.
15. Roth EJ, Fenton LL, Gaebler-Spira DJ, et al. Superior mesenteric artery syndrome in acute traumatic quadriplegia: case reports and literature review. Arch Phys Med Rehabil 1991; 72: 417–420.
16. Kitaura K, Harima K. Superior mesenteric artery syndrome with vascular calcification in a maintenance hemodialysis patient. Clin Nephrol 2009; 71: 228–230.
17. Bakker MEC, van Delft R, Vaessens NAL, Rosias PRR. Superior mesenteric artery syndrome in a 15-year-old boy during Ramadan. Eur J Pediatr 2014; 173: 1619–1621.
18. Zaraket V, Deeb L. Wilkie’s syndrome or superior mesenteric artery syndrome: Facto or fantasy. Case Rep Gastroenterol 2015; 9: 194–199.
19. Konen E, Amitai M, Apter S, et al. CT Angiogrpahy of superior mesenteric artery syndrome. AJR 1998; 171: 1279–1281.
20. Merrett ND, Wilson RB, Cosman P, Biankin AV. Superior mesenteric artery syndrome: diagnosis and treatment strategies. J Gastrointest Surg 2009; 13: 287–292.
21. Biank V, Werlin S. Superior mesenteric artery syndrome in children: a 20-year experience. J Pediatr Gastroenterol Nutr 2006; 42: 522–525.
22. Nishigucchi S, Shirobe T. Acute abdominal pain causesd by superior mesenteric artery syndrome in a healthy young boy. BMJ Case Rep 2016 Dec 19 pii: bcr2016217512. Doi 10.1136/bcr-2016-217512.
23. Barquin-Yaguez J, Abadía-Barno P, Garcia-Pérez JC. Superior mesenteric artery syndrome: an uncommon cause of intestinal obstruction. Rev Esp Enferm Dig 2017; 109: 60.
24. Gustafsson L, Falk A, Lukes PJ, Gamklou R. Diagnosis and treatment of superior mesenteric artery. Br J Surg 1984; 71: 499–501.
25. Moran TH. Gut peptides in the control of foof intake. Int J Obes 2009; 33 (Suppl 1): S7–S10.
26. Berry AJ. Pancreatic enzyme replacement therapy during pancreatic insufficiency. Nutr Clin Pract 2014; 29: 312–321.
27. Pandol SJ. Neurohumoral control of exocrine pancreatic secretion. Curr Opin Gastroenetrol 2003; 19: 443–446.
28. Chan DK, Mak KS, Cheah YL. Successful nutritional therapy for superior mesenteric artery syndrome. Singapore Med J 2012; 53: e233–e236.
29. Strong EK. Mechanism of arteriomesenteric duodenal obstruction and direct surgical attack upon etiology. Ann Surg 1958; 148: 725–730.
30. Sandmann W. Wilkie syndrom – ein seltenes Krankheitsbild und eine neue Therapie. Z Gastroenterol 2013; 51: K309.
31. Yakan S, Calıskan C, Kaplan H, et al. Superior mesenteric artery syndrome: a rare cause of intestinal obstruction. Diagnosis and surgical management. Indian J Surg 2013; 75: 106–110.
32. Love JA, Yi E, Smith TG. Autonomic pathways regulativ pancreatic exocrine secretion. Auton Neurosci 2007; 133: 19–39.
33. Konturek SJ, Zabielski R, Konturek JW, Czarnecki J. Neuroendocrinology of the pancreas; role of brain-gut axis in pancreatic secretion. Eur J Pharmacol 2003; 481: 1–14.
34. Li Y, Wu X, Zhu J, et al. Hypothalamic regulation of pancreatic secretion is mediated by central cholinergic pathway in the rat. J Physiol 2003; 552: 571–587.
35. Li Y. Sensory signal transduction in the vagal primary oferent neurons. Curr Med Chem 2007; 14: 2554–2563.
36. Li Y, Owyang C. Vagal afferent pathway mediates physiological action of cholecystokinin on pancreatic enzyme secretion. J Clin Invest 1993; 92: 418–424.
Labels
Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2017 Issue 8
Most read in this issue
- Thalassemias
- Chronic otitis media in childhood
- Brain abscess – a rare but a serious infection in childhood
- Thalassemias and hemoglobin variants in children