Which are the causes of Superior Mesenteric Artery Syndrome?

Superior Mesenteric Artery (SMA) Syndrome, also known as Wilkie's Syndrome, is a rare condition characterized by the compression of the third portion of the duodenum (the first part of the small intestine) between the superior mesenteric artery and the abdominal aorta. This compression leads to various gastrointestinal symptoms and can significantly impact a person's quality of life. While the exact cause of SMA Syndrome is not always clear, several factors have been identified as potential contributors to its development.

Predisposing Factors:

There are certain anatomical and physiological factors that can predispose individuals to develop SMA Syndrome:

• Rapid Weight Loss: One of the primary causes of SMA Syndrome is a significant and rapid loss of body weight. This can occur due to various reasons such as prolonged bed rest, severe illness, eating disorders, or bariatric surgery. The loss of adipose tissue around the SMA reduces the protective fat pad, increasing the risk of compression.


• Body Mass Index (BMI): Individuals with a low body mass index, typically below 18.5, are more susceptible to SMA Syndrome. The reduced fat and muscle mass in these individuals can contribute to the compression of the duodenum.


• Spinal Deformities: Certain spinal deformities, such as scoliosis or kyphosis, can alter the angle between the superior mesenteric artery and the abdominal aorta. This abnormal angle can lead to compression of the duodenum.


• Postural Changes: Certain body positions or postural changes can exacerbate the compression of the duodenum. For example, lying flat or in a prone position can increase the pressure on the duodenum, worsening the symptoms.

Other Contributing Factors:

In addition to the predisposing factors, there are other conditions and situations that can contribute to the development of SMA Syndrome:

• Abdominal Trauma or Surgery: Trauma or surgical procedures in the abdominal region can cause adhesions or scarring, which may lead to the compression of the duodenum.


• Malrotation of the Intestines: In some cases, individuals may have an abnormal rotation or fixation of the intestines, which can increase the risk of SMA Syndrome.


• Tumors or Masses: The presence of tumors or masses near the superior mesenteric artery can exert pressure on the duodenum, resulting in its compression.


• Intestinal Obstruction: Conditions that cause intestinal obstruction, such as Crohn's disease or volvulus, can indirectly contribute to SMA Syndrome by altering the position of the intestines and increasing the risk of compression.

It is important to note that while these factors are associated with SMA Syndrome, the exact cause can vary from person to person. Some individuals may develop the syndrome due to a combination of factors, while others may have no identifiable cause. Proper diagnosis and evaluation by healthcare professionals are crucial to determine the underlying cause and provide appropriate treatment.