Wilkie's Syndrome in a Patient with Major Dep...

Wilkie's Syndrome in a Patient with Major Depressive Disorder: A Rare Cause of Intestinal Obstruction

Author Name : Jorge A. Serrato Ruiz, Yeudiel Suro Santos, Jose E. Fuentes Hernandez, Javie A. Ruiz Yonser

ABSTRACT

Wilkie's syndrome, also known as Superior mesenteric artery (SMA) syndrome, is an unusual cause of proximal intestinal obstruction. It is associated with weight loss, serious diseases such as cancer, malabsorption syndromes, AIDS, trauma and burns. Symptoms are varied, which may begin acutely or insidiously with progressive symptoms. In mild cases there may be only postprandial epigastric pain and early satiety, while in more advanced cases the symptoms are more consistent with intestinal obstruction such as biliary emesis, nausea and weight loss. Physical examination is usually nonspecific, finding in some cases abdominal pain in the epigastrium, abdominal distension and increased peristalsis. Diagnosis requires imaging studies being the most common ones computed tomography, arteriography, magnetic resonance imaging and ultrasound. Finding duodenal obstruction, reduced angle and distance between the superior mesenteric artery and the aorta. The initial management consists of nasogastric tube, hydroelectrolytic correction and nutritional support, reserving surgical management for patients in whom conservative management has failed. The objective of this report is to present the case of a patient with Wilkie's syndrome; an unusual pathology with few documented cases of intestinal obstruction.

Keywords: Adult, Duodenum, Intestinal Obstruction / etiology, Superior Mesenteric Artery Syndrome.