Ultrasound imaging in diagnosis of superior mesenteric artery syndrome

J Intern Med. 2005 Apr;257(4):346-51. doi: 10.1111/j.1365-2796.2005.01456.x.


Objectives: We screened a cohort of subjects affected by various degree of dyspepsia to reveal if they presented a reduction of the aorto-mesenteric angle and to diagnose suspected cases of superior mesenteric artery (SMA) syndrome.

Design: Controlled, prospective, study.

Setting: Subjects were studied as outpatients.

Subjects: The study investigated a total of 3622 subjects referred to our department by their general practitioners for dyspepsia and/or abdominal pain. Interventions. Abdominal ultrasonography with power colour Doppler, gastroduodenoscopy, hypotonic duodenography, contrast-enhanced spiral computerized tomography were performed. MAIN OUTCOME MEASUREMENT AND RESULTS: Color Doppler revealed a significant reduction of the SMA angle in 29 of 950 subjects; gastroscopy showed duodenal compressive pulsation in 14 of 29 patients and X-ray revealed compression of the third segment of the duodenum in 28 of 29 patients. CT confirmed the presence of a reduced angle and various degrees of duodenal compression in all patients. Ultrasonography and CT examinations gave overlapping results (P > 0.05) in diagnosing pathological aorto-mesenteric angle.

Conclusion: The authors believe that the incidence of reduced aorto-mesenteric angle and SMA syndrome might be underrated. Ultrasound power colour Doppler imaging is useful in epidemiological screening of reduced aorto-mesenteric angle to diagnose suspected cases of SMA syndrome.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Pain / diagnostic imaging
  • Adult
  • Aorta / diagnostic imaging
  • Aorta / pathology
  • Dyspepsia / diagnostic imaging
  • Female
  • Gastroscopy
  • Humans
  • Male
  • Mesenteric Artery, Superior / diagnostic imaging
  • Mesenteric Artery, Superior / pathology
  • Posture
  • Prospective Studies
  • Superior Mesenteric Artery Syndrome / diagnostic imaging*
  • Superior Mesenteric Artery Syndrome / pathology
  • Tomography, Spiral Computed
  • Ultrasonography, Doppler, Color