The overlooked obstruction: Wilkie syndrome in small bowel blockages - Insights from a hospital case series.

Abstract

Superior Mesenteric Artery Syndrome (SMAS) is a rare cause of proximal intestinal obstruction in young adults. This case series aims to describe the clinical presentation, diagnostic findings, and management outcomes in affected patients. We describe the information of eight patients diagnosed with SMAS. We collected clinical, laboratory, and radiological data and treatment approaches. The median age was 22 years (16-31), and a male predominance (62%). All patients had oral intake intolerance, with nausea (87%), dyspepsia (50%), and abdominal pain (37%) being the most common symptoms. The median Nutritional Risk Screening (NRS) score was 4. Imaging revealed a reduced aortomesenteric angle (median: 16.6°) and distance (median: 4 mm). Treatment varied based on severity, with 50% requiring surgical intervention. Two patients died due to unrelated complications. SMAS remains a challenging diagnosis due to its nonspecific and progressive symptoms. Early identification of risk factors and individualized management strategies are crucial for improving patient outcomes.