I have SMA sydrome found on ct scan with contrast after losing going from 130 pounds to 109 pounds in a year of constant nausea last week I have gone down from 116 pounds to 109 pounds and constant nausea and agonizing pain in lower abdomen. My condition is so bad I got another diagnosis on top of everything which is chronic fatigue syndrome and it’s not my fault because I have been averaging 2700-3000 calories a day for the last 4 years and haven’t had a problem until a year ago. I have been forced not to eat lunch since nausea peaks at this time so I’m stuck eating a 1,500 calorie breakfast and a 1,500 calorie dinner and nearly dying of dehydration even though I’m consuming 5 liters of liquid a day.
Very informative. I’m a veteran and I had this exact problem. It’s nice to better understand what was going on in my body. I’m 2 weeks post surgery and things are getting better each day
Why foes nobody ever mention EDS is. Big cause of this. Rapid weight-loss is not the only reson this happens. Thousands of patients who have been diagnosed usually have EDS or some type of connective tissue disorder. It NEEDS to be mentioned.
And building on from that then we get patients with lung pathology too, ie those associated with connective tissue disorders, collagen or genetic, who also have SMA. Imagine that, connective tissue disease, serious lung disease, and then problems with digestive system inter alia SMA. Whoever coined the phrase “multiple pathologies are rare” really doesn’t know what they are talking about. Human body really sucks.
Hello doctor my father diagnosis complete luminal occlusion of proximal main stem of superior mesenteric artery of approximately 4cm length segment from origin,however normal contrast opacification in distal main stem and branches through collaterals.
I got this diagnosis. Haven’t had issues in the past but having bad symptoms now. My aortomesenteric angle measuring 14 degrees. The aortomesenteric distance is also decreased measuring 0.4cm. I have Crohn’s disease as well. Does surgery help if I can’t gain weight? Been a huge struggle the past 5 years
I just found out I have sma. I had bariatric surgery 3 years ago and have lost 217lbs . I’m assuming I developed this because of my weight loss. Will my vascular surgeon do both parts of that surgery or should I specially mention both? 😢I’m so scared of another surgery.
The stomach, first, second and third part of the duodenum are dilated up to the midline at the level of SMA crossing there is abrupt transition is seen. The SMA angle is near the lower limit measuring 30° and the SMA distance from the abdominal aorta is also at the lower limit measuring 8 mm. The rest of the bowel loops appear normal. No ascites is seen. No significant abdominal or pelvic lymphadenopathy is seen.
Have had symptoms extending back to childhood of early satiety, bouts of nausea, and upper GI pain/spasms. You mention rapid weight loss but that hasn’t happened with me though a 14 degree angle and 6mm between arteries was recently caught on CT and CTA. Dealing with a bad bout now but I don’t vomit. Also, dealing with chronic malabsorption issues. I am a nurse and have always forced nutrition and treated symptoms but my bouts seem to be worsening. Had to pull out of grad school for a year. Do you see chronic intermittent cases ever?
I’m researching surgical intervention because, honestly, I’m very aware of my nutritional needs and I’ve always done everything to counter these bouts and not lose too much weight. Wish there was a really good study out there comparing all the surgical interventions because I’m done with the “conventional” method I’ve essentially been doing for years. I’m out East so I’m trying to get to an SMA specialist out this way. But would really like to thoroughly compare pros and cons of various surgeries. Is your double approach procedure essentially more fool proof? Do you do the DDJ in addition to the Strong’s in case it were to try to move back? My greatest fear is adhesions and scar tissue causing other problems. And that was me just commenting through my husband’s account above- same person, lol.
Ok,thanks;so initially should treat the cause ,especially those younger patients have psychiatric elements like anorexia nervosa,PLUS nutritional support (TPN)with considerable attention to the severity and the duration (surgical intervention should be nearly considered)
Have GERD and took Omeprazole for about a year. Stopped and don’t have much issue with it anymore. Negative gastroparesis from emptying tests. Not sure on the MALS but I would imagine it would have shown up on one of my prior tests?
sometimes MALS does not show up on any imaging tests. However, if you have a good response to a celiac ganglion nerve block, MALS should still be in the differential diagnosis.
Yes it can. A CT scan with IV contrast of the abdomen is a key test. If the angle between the aorta and SMA are less than 18 degrees, that is very suspicious for SMAS. 18-22 degrees is gray zone. Symptoms must correlate, of course. Please call our office for a formal consultation if you would like to discuss further.
Dr Shouhed fixed my daughter’s SMAS when none else would help her. She was 100% reliant on TPN and can now eat anything she wants. He literally saved her life!
I have SMA sydrome found on ct scan with contrast after losing going from 130 pounds to 109 pounds in a year of constant nausea last week I have gone down from 116 pounds to 109 pounds and constant nausea and agonizing pain in lower abdomen. My condition is so bad I got another diagnosis on top of everything which is chronic fatigue syndrome and it’s not my fault because I have been averaging 2700-3000 calories a day for the last 4 years and haven’t had a problem until a year ago. I have been forced not to eat lunch since nausea peaks at this time so I’m stuck eating a 1,500 calorie breakfast and a 1,500 calorie dinner and nearly dying of dehydration even though I’m consuming 5 liters of liquid a day.
Very informative. I’m a veteran and I had this exact problem. It’s nice to better understand what was going on in my body. I’m 2 weeks post surgery and things are getting better each day
it is not only from weight loss, i was born with this. my obstruction is almost fully parallel at 9 degrees
Thank you Doc 🎉
Hello sir your video is amazing … but can we recover by weight gain ?
Yes sometimes
I'm getting the strong px done soon and I'm scared as hell.
I m also diagnosed and I cured it.. now I m Fine
What is the treatment please?
@@Rtvmo565 Surgery
@imrankhan0088 kya treatment liya??
Which test can confirm sma syndrome
CT Abdomen @@samikshyakharel1284
Thank you!
My Dr believes I have SMAS Syndrome. I will be having a CT scan done to determine if I have that disease or not.
Why foes nobody ever mention EDS is. Big cause of this. Rapid weight-loss is not the only reson this happens. Thousands of patients who have been diagnosed usually have EDS or some type of connective tissue disorder. It NEEDS to be mentioned.
Yes EDS can be a primary etiology as well.
And building on from that then we get patients with lung pathology too, ie those associated with connective tissue disorders, collagen or genetic, who also have SMA. Imagine that, connective tissue disease, serious lung disease, and then problems with digestive system inter alia SMA. Whoever coined the phrase “multiple pathologies are rare” really doesn’t know what they are talking about. Human body really sucks.
What is EDS?
Ehlers-Danlos syndrome
Hello doctor my father diagnosis complete luminal occlusion of proximal main stem of superior mesenteric artery of approximately 4cm length segment from origin,however normal contrast opacification in distal main stem and branches through collaterals.
I got this diagnosis. Haven’t had issues in the past but having bad symptoms now. My aortomesenteric angle measuring 14 degrees. The aortomesenteric distance is also decreased measuring 0.4cm.
I have Crohn’s disease as well. Does surgery help if I can’t gain weight? Been a huge struggle the past 5 years
I’m sorry you are struggling. Yes surgery can be successful if the diagnosis is correct.
I just found out I have sma. I had bariatric surgery 3 years ago and have lost 217lbs . I’m assuming I developed this because of my weight loss. Will my vascular surgeon do both parts of that surgery or should I specially mention both? 😢I’m so scared of another surgery.
The stomach, first, second and third part of the duodenum are dilated up to the midline at
the level of SMA crossing there is abrupt transition is seen. The SMA angle is near the
lower limit measuring 30° and the SMA distance from the abdominal aorta is also at the
lower limit measuring 8 mm. The rest of the bowel loops appear normal. No ascites is seen.
No significant abdominal or pelvic lymphadenopathy is seen.
Have had symptoms extending back to childhood of early satiety, bouts of nausea, and upper GI pain/spasms. You mention rapid weight loss but that hasn’t happened with me though a 14 degree angle and 6mm between arteries was recently caught on CT and CTA. Dealing with a bad bout now but I don’t vomit. Also, dealing with chronic malabsorption issues. I am a nurse and have always forced nutrition and treated symptoms but my bouts seem to be worsening. Had to pull out of grad school for a year. Do you see chronic intermittent cases ever?
Yes those numbers sound concerning for SMAS.
I’m researching surgical intervention because, honestly, I’m very aware of my nutritional needs and I’ve always done everything to counter these bouts and not lose too much weight. Wish there was a really good study out there comparing all the surgical interventions because I’m done with the “conventional” method I’ve essentially been doing for years. I’m out East so I’m trying to get to an SMA specialist out this way. But would really like to thoroughly compare pros and cons of various surgeries. Is your double approach procedure essentially more fool proof? Do you do the DDJ in addition to the Strong’s in case it were to try to move back? My greatest fear is adhesions and scar tissue causing other problems.
And that was me just commenting through my husband’s account above- same person, lol.
The corner stone for diagnosing SMA(Wilki)syndrome is THE RAPID WEIGHT LOSS+ITS SOURCE
Absolutely
Ok,thanks;so initially should treat the cause ,especially those younger patients have psychiatric elements like anorexia nervosa,PLUS nutritional support (TPN)with considerable attention to the severity and the duration (surgical intervention should be nearly considered)
Nutcracker syndrome varicocele problem please help me sir
The music makes it difficult to concentrate on the explanation. Thank you!
for a 12 year old what do you recommend
My daughter diagnosed has a SMAS
Can sma symdrome cured weight gain … i am suffering from 2 years and dr told me weight gain
Any advice for a 34yo male post DDJ who has SMA and Nutcracker but never gained weight after surgery? Still 130lbs.
Search for other diagnoses (ie MALS, Gastroparesis, GERD)..
Have GERD and took Omeprazole for about a year. Stopped and don’t have much issue with it anymore. Negative gastroparesis from emptying tests. Not sure on the MALS but I would imagine it would have shown up on one of my prior tests?
sometimes MALS does not show up on any imaging tests. However, if you have a good response to a celiac ganglion nerve block, MALS should still be in the differential diagnosis.
Can weight gain is help to improved sma syndrome ? And can i eat whey protien during sma syndrome
Yes sometimes. I don’t see any reason why you can’t have whey protein.
Does barium swallow test detect sma syndrome
Yes it can. A CT scan with IV contrast of the abdomen is a key test. If the angle between the aorta and SMA are less than 18 degrees, that is very suspicious for SMAS. 18-22 degrees is gray zone. Symptoms must correlate, of course. Please call our office for a formal consultation if you would like to discuss further.
Does same test detect smas and mals
I asked to my vascular dr he ordered me vascular ultrasound of abdomen aorta is it test that can detect
@@samikshyakharel1284I just had that done and that’s what hinted I have sma. I believe I now have to have a iv contrast of my stomach to confirm it.
Which is better CT of pelvis and abdomen with contrast and liquid drink or CT angio for SMAS , and what for mals ?
the child also has another narrowing of the nutcracker
I would say that some of your pts with this probably have ehlers danlos syndrome
Weight gain help solve SMA
I dont know what am i do.. they said that there is no cure to this rare sick
Surgery is the only thing that corrects it. Or, you can live off of TPN, but I wouldn't suggest that.
@@karagrace2744 @cloudsuba3897 Actually, that is not complete correct. There are 2 ways to fix it, either gaining weight back or surgery.
You need to either gain the weight back by medications, TPN, ect.. or surgery if that does not work.
Dr Shouhed fixed my daughter’s SMAS when none else would help her. She was 100% reliant on TPN and can now eat anything she wants. He literally saved her life!
She is only 2 yrs and 10 months old
I guess I have it 😢