Superior mesenteric artery syndrome in traumatic brain injury: two cases

One of the many causes of enteral feeding (EF) intolerance after traumatic brain injury (TBI) is superior mesenteric artery syndrome (SMAS). Although it is reported in pediatric brain injury, few cases are noted in adults. To increase awareness of this medically treatable condition, we present two p...

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Bibliographic Details
Published in:	Archives of physical medicine and rehabilitation Vol. 76; no. 9; p. 871
Main Authors:	Pedoto, M J, O'Dell, M W, Thrun, M, Hollifield, D
Format:	Journal Article
Language:	English
Published:	United States 01-09-1995
Subjects:	Adult Brain Injuries - complications Enteral Nutrition - adverse effects Female Humans Male Radiography Risk Factors Superior Mesenteric Artery Syndrome - diagnostic imaging Superior Mesenteric Artery Syndrome - etiology
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Summary:	One of the many causes of enteral feeding (EF) intolerance after traumatic brain injury (TBI) is superior mesenteric artery syndrome (SMAS). Although it is reported in pediatric brain injury, few cases are noted in adults. To increase awareness of this medically treatable condition, we present two patients who developed SMAS after sustaining severe brain injury. SMAS results from compression of the duodenum by the SMA against the aorta and risk factors include acute weight loss, prolonged recumbency, and spasticity--all frequently encountered in severe TBI. After gastric decompression, symptoms often resolve with weight gain achieved by conservative treatment; including feeding in the left lateral or prone position, hyperalimentation, or extension of a feeding tube beyond the obstruction. SMAS should be considered in the presence of EF intolerance in severe adult TBI because multiple risk factors may be present.
ISSN:	0003-9993
DOI:	10.1016/S0003-9993(95)80555-9