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Pancreatic exocrine insufficiency in superior artery mesenteric syndrome – Wilkie syndrome: rationale and practical considerations on exocrine dysfunction after surgical attacks


Authors: R. Petro 1;  T. Malý 2;  S. Kupková 3;  K. Veselská 4;  J. Schwarz 5;  R. Pomahačová 5;  M. Kreslová 5;  A. Masopustová 5;  M. Huml 5;  J. Sýkora 5
Authors‘ workplace: Ambulance pro dětskou gastroenterologii, Nemocnice Karviná 1;  Chirurgická klinika FN, Lékařská fakulta Univerzity Palackého, Olomouc 2;  Radiologické oddělení, Nemocnice Karviná-Ráj 3;  Ordinace praktického lékaře pro děti a dorost, Petrovice u Karviné 4;  Dětská klinika, Univerzita Karlova, Lékařská fakulta v Plzni, Fakultní nemocnice, Plzeň 5
Published in: Čes-slov Pediat 2017; 72 (8): 478-488.
Category: Case Report

Overview

Superior mesenteric artery (SMA) syndrome is an uncommon cause of upper bowel obstruction. SMA syndrome is linked to unspecific upper digestive symptomps. The main point of this research is the presence of exocrine pancreatic insufficiency (EPI) linked to SMA syndrome assessed by fecal elastase-1. EPI was proposed as the underlying pathogenesis, thus this group of children necessitates routine screening for pancreatic dysfunction.

There are several types of appropriate therapeutic options and the patophysiological aspects of the changes on EPI after surgical approaches were discussed. We suggest that SMA syndrome must be considerd as a new cause of exocrine pancreatic dysfunction.

Key words:
superior mesenteric artery syndrome, exocrine pancreatic dysfunction, fecal elastase-1, operation


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Neonatology Paediatrics General practitioner for children and adolescents
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