Weight loss: a cause or a consequence of wilkie’s syndrome

The Superior mesenteric artery syndrome (SMAS) known as Wilkie's syndrome is a rare cause of duodenal obstruction. It is a disorder in which acute angulation of the SMA causes compression of the third part of the duodenum between the SMA and the aorta, following the disappearance of perivascular fatty tissue after advanced malnutrition. The diagnosis requires a high degree of clinical suspicion of upper gastrointestinal obstruction plus progressive weight loss, with radiographic studies demonstrating compression of the third portion of the duodenum. The severity of the symptoms depends on the aortomesenteric angle and the degree of the compression. The treatment is medical, but in case of failure, surgery is necessary.