Superior mesenteric artery syndrome

Introduction: The aim of this paper was to describe a rare gastrointestinal motility disorder caused by vascular compression of the duodenum. Patients : The authors present two patients with vomiting and severe weight loss. Di agnostic evaluation revealed superior mesenteric artery syndrome. Methods: After frustrane treatment with i.v. infusions, surgical intervention with l aterolateral duodenojejunostomy or Roux-en-y reconstruction for restoration of the intestinal passage was performed. Results: Following initial recove ry, the first patient showed permanent anorexia. Psychosocial evaluation re vealed a severe pathological mother-child relationship. Intensive psycholog ical treatment finally achieved definite weight gain and complete recovery in this patient. The second case subsequently gained weight without psychol ogical evaluation. Conclusion: The authors review the literature, pointing out the anatomy of the duodenojejunal angle, the etiology, and the predispo sing factors, as well as diagnostic and therapeutic strategies.