Assessment of duodenal circular drainage in treatment of superior mesenteric artery syndrome

AIM: To assess the clinical value of duodenal circular drainage for superior mesenteric artery syndrome (SMAS).METHODS: Forty-seven cases of SMAS were treated with duodenal circular drainage from 1959 to 2001.Clinical data were analyzed retrospectively.RESULTS: In this group, good effects were achieved in 39 cases treated with duodenal circular drainage after 2-15 years of follow-up. The other eight cases were first treated with anterior repositioning of the duodenum (two cases), duodenojejunostomy (five cases), subtotal gastrectomy and billroth 11 gastrojejunostomy (one case), but vomiting was not relieved until duodenal circular drainage was performed again. A follow-up study of 8-10 years revealed satisfactory results in these eight patients.CONCLUSION: In SMAS, if the reversed peristalsis is strong and continuous, and vomiting occurs frequently,the symptom can not be relieved even if the obstruction of duodenum is removed surgically. The key treatment is the relief of reversed peristalsis. The duodenal circular drainage can resolve the drainage direction of duodenal content, thus relieving the symptom of vomiting.