From the Research
Lewis summer syndrome, also known as Superior Mesenteric Artery Syndrome, is a rare condition that requires early diagnosis and treatment to prevent complications, and the initial treatment is usually conservative, including postural change, gastroduodenal decompression, and nutrient management, with a success rate of 70%-80%. The syndrome is caused by compression of the duodenum between the superior mesenteric artery and the aorta, leading to symptoms such as postprandial abdominal pain, nausea, vomiting, early satiety, anorexia, and weight loss 1. The diagnosis can be made using computed tomography as a standard tool and ultrasonography, which has advantages in safety and capability of real-time assessments of SMA mobility and duodenum passage 1.
The treatment of Lewis summer syndrome typically involves conservative management, including enteral nutritional therapy, which has been shown to improve nutritional status and symptom improvement at a short-term follow-up 2. The use of enteral nutrition therapy has been reported to increase serum levels of nutritional indicators, BMI, and body weight, and decrease symptom scores 2. In cases where conservative therapy fails, surgical treatment, such as laparoscopic duodenojejunostomy, may be recommended, with a success rate of 80%-100% 1.
It is essential to note that Lewis summer syndrome can mimic other conditions, such as anorexia nervosa or functional dyspepsia, and a high index of suspicion is required to make the diagnosis 1. The prognosis is generally favorable, with proper management able to significantly improve quality of life and prevent long-term complications 1.
Key points to consider in the management of Lewis summer syndrome include:
- Early diagnosis and treatment to prevent complications
- Conservative management, including postural change, gastroduodenal decompression, and nutrient management, as the initial treatment
- Use of enteral nutritional therapy to improve nutritional status and symptom improvement
- Surgical treatment, such as laparoscopic duodenojejunostomy, in cases where conservative therapy fails
- Regular follow-up appointments to monitor disease activity and medication side effects.