Nutcracker and SMA syndromes: What is the normal SMA angle in children?

European Journal of Radiology
O J ArthursP A K Set

Abstract

The nutcracker and superior mesenteric artery (SMA) syndromes are rare conditions where the left renal vein or duodenum may be compressed by an unusually acute angle between the SMA and aorta, although the normal angle in children is unknown. We measured the SMA angle to define the normal range in children. We retrospectively measured SMA angles, left renal vein (LRV) distance, and duodenal distance (DD) in 205 consecutive pediatric abdominal CT. Total and visceral intra-abdominal fat at the level of the umbilicus were also assessed. Mean SMA angle was 45.6±19.6° (range 10.6-112.9°), mean LRV distance was 8.6±3.9mm (range 2.0-28.6mm) and mean DD was 11.3±4.8mm (range 3.6-35.3mm). There was a significant but weak correlation between %visceral fat volume (%VF) and SMA angle (R=0.30; p<0.001), LRV distance (R=0.37, p<0.001) and DD (R=0.32; p<0.001). There is a wide range of SMA angle, LRV and DD in normal children, which correlated weakly with visceral fat volume. Using a definition of SMA angle <25° would diagnose 9.3% of asymptomatic children with nutcracker syndrome, and using a DD definition of <8mm would diagnose 20% with SMA compression. Our findings suggest exercising caution when attributing these rare syndromes to an abso...Continue Reading

References

Dec 1, 1976·American Journal of Diseases of Children·S S Gellis
Nov 1, 1992·Nihon Hinyōkika Gakkai zasshi. The japanese journal of urology·A ImamuraY Saito
Jan 1, 1991·Pediatric Radiology·R SanterM M Riddlesberger
Jan 1, 1982·Clinical Radiology·J R AndersonG M Fraser
Jan 1, 1996·Radiology·S H KimM C Han
Apr 6, 1999·Radiology·T YoshizumiY Matsuzawa
Mar 25, 2005·Journal of Internal Medicine·S NeriR Scuderi
Aug 3, 2006·International Journal of Urology : Official Journal of the Japanese Urological Association·Wei-Jun FuXiao Xiong Wang
Mar 13, 2009·Surgical and Radiologic Anatomy : SRA·Nilgun Isiksalan OzbulbulTulay Olcer
Dec 19, 2009·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Byoung Soo ChoJoo Won Lim

❮ Previous
Next ❯

Citations

Aug 3, 2014·European Journal of Radiology·Seong Jong YunJi Su Kim
Nov 28, 2013·Kidney International·Se Jin Park, Jae Il Shin
Mar 24, 2016·Pediatric Radiology·Dana I DumitriuPhilippe Clapuyt
May 24, 2016·Singapore Medical Journal·Yusheng Keefe Lai, Rameysh Danovani Mahmood
Aug 21, 2013·Journal of Korean Medical Science·Myung Seok Shin, Jae Young Kim
Feb 2, 2018·Insights Into Imaging·Sergi JuanpereSalvador Pedraza
Aug 14, 2019·Journal of Paediatrics and Child Health·Anastasia DimopoulouAchilleas Attilakos
Apr 30, 2015·European Journal of Pediatrics·Sevgi YavuzOrhan Korkmaz
Sep 19, 2018·Gastroenterology Research and Practice·Emanuele SinagraMassimo Midiri
Feb 12, 2021·Journal of Surgical Case Reports·Maysaa BadourAli Hammed
Jun 29, 2021·Jornal Vascular Brasileiro·Adenauer Marinho de Oliveira GóesWaldonio de Brito Vieira

❮ Previous
Next ❯

Related Concepts

Related Feeds

Anorexia Nervosa

Anorexia nervosa (AN) is a psychiatric condition characterized by severe weight loss and secondary problems associated with malnutrition. Here is the latest research on AN.

Birth Defects

Birth defects encompass structural and functional alterations that occur during embryonic or fetal development and are present since birth. The cause may be genetic, environmental or unknown and can result in physical and/or mental impairment. Here is the latest research on birth defects.

Related Papers

Pediatric Nephrology : Journal of the International Pediatric Nephrology Association
Jae Il ShinMyung Joon Kim
The American Journal of Medicine
Filippo MearelliGianni Biolo
International Journal of Urology : Official Journal of the Japanese Urological Association
Jae Il ShinMyung Joon Kim
Pediatric Nephrology : Journal of the International Pediatric Nephrology Association
Jae Il ShinMyung Joon Kim
© 2021 Meta ULC. All rights reserved