Wilkie-Syndrom@@@Wilkie’s syndrome: Chronisches Erbrechen und „hoher Ileus“ durch duodenale Kompression zwischen Aorta und A mesenterica superior@@@Chronic vomiting and high ileus caused by intermittent duodenal compression between the aorta and superior mesenteric artery

The difficulties encountered in the diagnosis of superior mesenteric artery syndrome (Wilkie’s syndrome) are described based on the experience with surgery in three typical cases carried out 5 years, 3 years and 5 months ago, respectively. The vascular reconstructive procedure by transposition of the superior mesenteric artery into the infrarenal aorta is also described as an alternative to gastrointestinal anastomosis. All patients were free of symptoms 6 weeks after the transposition and the stenosis of the inferior horizontal section of the duodenum could no longer be detected by imaging. No healing problems were encountered even in the particular situation of a young girl affected by Ehlers-Danlos syndrome. The advantages of autologous vascular reconstruction in relation to gastrointestinal surgery are demonstrated and the impact of modern imaging for early diagnosis, especially the lateral view by computed tomography (CT) angiography is underlined. In general in the presence of abdominal pain and weight loss the importance and presence of arteries in the abdomen are often forgotten leading to late or misdiagnosis.