[Superior mesenteric artery syndrome (Wilkie syndrome): case report]. / Síndrome de la arteria mesentérica superior (síndrome de Wilkie): Caso clínico.

Superior mesenteric artery syndrome is an uncommon cause of upper gastrointestinal tract obstruction. The syndrome results from compression of the third portion of duodenum as it crosses underneath the superior mesenteric artery, related to conditions that reduce the aortomesenteric angle (acute weight loss) or after scoliosis surgery. Patients may present symptoms of gastrointestinal obstruction, such as upper abdominal distension and epigastric tenderness, usually relieved by posture changing. Diagnose must be complemented with an upper gastrointestinal barium-contrast radiography. Conservative treatment is usually effective with early diagnosis. Surgery is needed when conservative measures are ineffective. We present the case of a 18 year-old patient with Wilkie's syndrome secondary to scoliosis surgery. The patient presented symptoms of gastrointestinal obstruction, and diagnosis was confirmed with upper gastrointestinal barium-contrast radiography. The patient started conservative treatment with proper positioning after eating and nutritional support to provide optimal calories supply.

Síndrome de la arteria mesentérica superior (síndrome de Wilkie): caso clínico / Superior mesenteric artery syndrome (Wilkie syndrome): case report

El síndrome de la arteria mesentérica superior (síndrome de Wilkie) es una causa poco frecuente de obstrucción duodenal de origen vascular. Se asocia con situaciones que disminuyen elángulo entre la arteria mesentérica superior y la aorta (compásaortomesentérico) secundarias a pérdida de grasa retroperitoneal (descenso brusco de peso o caquexia) o procedimientos que determinan hiperextensión dorsal, especialmente enpostquirúrgicos de cirugía correctora de escoliosis. Clínicamente, se manifiesta por obstrucción intestinal alta. El diagnósticoes radiológico y el tratamiento es inicialmente médico. El tratamiento quirúrgico se reserva para casos refractarios. Se describe el caso de un paciente de 18 años con síndrome de Wilkie, secundario a cirugía correctora de escoliosis dorsolumbar. Con la sospecha clínica se realiza seriada gastroduodenal que confirma el diagnóstico. Inicia tratamiento médico con dieta hipercalórica fraccionada y medidas posturales con buena respuesta.