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Superior Mesenteric Artery Syndrome
(SMAS)
Superior Mesenteric Artery Syndrome (SMAS) is a rare digestive condition that causes obstruction of the 3rd portion of the duodenum due to compression by the Superior Mesenteric Artery and the Abdominal Aorta.
This leads to symptoms such as feeling full quickly, nausea and vomiting, abdominal pain, and weight loss.
WHAT IS SMAS?
WHAT CAUSES SMAS?
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SMAS has a variety of causes, most of which relate to the SMA-aortic angle. The intestine is located in between these two arteries, and if the space between them is too small, the intestine is compressed or squished. This makes it is more difficult for food to pass through, like trying to drink out of a straw that is being crushed.
The angle can be reduced by loss of the mesenteric fat pad. The fat pad is fatty tissue that surrounds the mesenteric artery and helps to hold open the angle. Weight loss causes the fat pad to reduce and the angle to narrow. Spinal conditions, surgery, bedrest, and comorbid diseases can also cause the angle to narrow.
Check out these scans!
Two measurements are especially important for the diagnosis of SMAS:
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The distance between the SMA and Aorta
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Normal = 28-65 degrees
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SMAS = 6-22 degrees
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The angle between the SMA and Aorta
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Normal = 10-34 mm
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SMAS = 2-8 mm
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COULD I HAVE SMAS?
Causes
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Loss of fat pad
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Weight loss
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Congenital predisposition
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Elongated mesentery
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Rapid growth spurt
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Spinal conditions
Symptoms
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Feeling full quickly when eating
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Bloating after meals
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Burping (belching)
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Nausea
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Vomiting of partially digested food
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Vomiting of bile-like liquid
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Small bowel obstruction
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Weight loss
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Mid-abdominal pain
Diagnostics
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Diagnostics
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CT angiogram (CTA)
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Doppler ultrasound
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Contrast study (UGIS)
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Barium swallow
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Exclusion testing
TREATMENT OPTIONS
Management
The first line of treatment is often management via high-calorie diets, positioning, and feeding tubes.
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Surgical Options
There are several surgical options for SMAS that have great success rates.
Diet & Nutrition
High-calorie diets and meal replacement shakes are ideal to regain the mesenteric fat pad.
Common Comorbidities
SMAS patients may have these conditions as well:
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*Provider submissions are provided by patients and have no affiliation with the SMAS Nonprofit.
