Superior mesenteric artery syndrome in acute traumatic quadriplegia: Case reports and literature review

Elliot J. Roth*, Lynne L. Fenton, Deborah J. Gaebler-Spira, Frederick S. Frost, Gary M. Yarkony

*Corresponding author for this work

Research output: Contribution to journalArticle

31 Scopus citations

Abstract

Superior mesenteric artery syndrome is a condition in which the third portion of the duodenum is intermittently compressed by the overlying superior mesenteric artery, resulting in gastrointestinal obstruction. Predisposing factors include rapid weight loss, prolonged supine positioning, and using a spinal orthosis, all of which are common among acute traumatic quadriplegic patients. This paper presents three patients, aged 24, 16, and 20 years, with traumatic quadriplegia treated with supine positioning and cervical orthoses, who had postprandial nausea and emesis, bloating, and abdominal pain during rehabilitation. Upper gastrointestinal radiographic series demonstrated abrupt duodenal obstruction to barium flow in all three patients. Two of the patients had complete relief of symptoms with conservative management, and one required surgical duodenojejunostomy. Enhanced awareness of this condition may result in improved recognition of this disease as a cause of persistent, unexplained gastrointestinal disturbances in quadriplegic persons, thereby optimizing its treatment and reducing its potential morbidity.

Original languageEnglish (US)
Pages (from-to)417-420
Number of pages4
JournalArchives of physical medicine and rehabilitation
Volume72
Issue number6
StatePublished - May 1991

Keywords

  • Duodenal obstruction
  • Mesenteric vascular occlusion
  • Quadriplegia
  • Spinal cord injuries

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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