Das aortomesenteriale Kompressionssyndrom

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. Diagnostic evaluation revealed superior mesenteric artery syndrome.

METHODS: After frustrane treatment with i.v. infusions, surgical intervention with laterolateral duodenojejunostomy or Roux-en-y reconstruction for restoration of the intestinal passage was performed.

RESULTS: Following initial recovery, the first patient showed permanent anorexia. Psychosocial evaluation revealed a severe pathological mother-child relationship. Intensive psychological treatment finally achieved definite weight gain and complete recovery in this patient. The second case subsequently gained weight without psychological evaluation.

CONCLUSION: The authors review the literature, pointing out the anatomy of the duodenojejunal angle, the etiology, and the predisposing factors, as well as diagnostic and therapeutic strategies.