Henry Ford Hospital Medical Journal


Compression of the duodenum by the root of the mesentery is a rare pathological entity that has caused much controversy because it has been mistakenly identified as the "superior mesenteric artery syndrome" or the "vascular compression of the duodenum." We discuss the pathological anatomy and the diagnosis of the disease, and report an illustrative case. Some authors report many cases of the syndrome, while others doubt its existence. Before surgery is considered, the diagnosis should be established beyond doubt and a prolonged period of observation, medical treatment, and nutritional support should be provided. The barium contrast swallowing test combined with aortographic studies can pinpoint the compression site behind the root of the mesentery. Good surgical results have been reported with both dextroposition of the duodenojejunal junction and with duodenojejunostomy.