A case of superior mesenteric artery syndrome after atrial fibrillation catheter ablation in which abdominal ultrasound was useful
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- KAWABATA Kazumi
- Department of Gastroenterology, Hanwa Memorial Hospital
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- YATA Yutaka
- Department of Gastroenterology, Hanwa Memorial Hospital
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- TAKADA Sayuri
- Department of Gastroenterology, Hanwa Memorial Hospital
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- TANAKA Tsuneyuki
- Department of Gastroenterology, Hanwa Memorial Hospital
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- IKEO Kouichi
- Department of Gastroenterology, Hanwa Memorial Hospital
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- MIYAMOTO Hayato
- Department of Gastroenterology, Hanwa Memorial Hospital
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- NAKAGAWA Yasuki
- Department of Gastroenterology, Hanwa Memorial Hospital
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- NAKAJIMA Noriyuki
- Department of Gastroenterology, Hanwa Memorial Hospital
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- MIYAZAKI Junichi
- Department of Gastroenterology, Hanwa Memorial Hospital
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- ABE Takashi
- Department of Gastroenterology, Hanwa Memorial Hospital
Bibliographic Information
- Other Title
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- 体位変換による腹部超音波検査が有用であった心房細動カテーテルアブレーション後の上腸間膜動脈症候群の1例
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Abstract
<p>The patient was a 58-year-old male. He was admitted to our hospital with anorexia, weight loss (-10 kg/2 months), and repeated vomiting after radiofrequency catheter ablation (RFCA) for atrial fibrillation. Abdominal CT showed marked gastric dilatation and partial dilatation and collapse of the third portion of the duodenum. Since a part of the third portion of the duodenum was compressed by the superior mesenteric artery (SMA) and the aorta (Ao), we diagnosed SMA syndrome. Ultrasonography utilizing positional changes revealed that the distance between the SMA and Ao varied from 6.0 mm in the supine position, 40.1 mm in the left lateral recumbent position, 30.8 mm in the right lateral recumbent position, and 7.7 mm in the sitting position, with duodenal compression being reduced most in the left lateral recumbent position. After hospitalization and instruction in mosapride citrate administration, divided meals, and left-side supine position after meals, his symptoms including vomiting resolved.The patient was discharged from the hospital without any symptoms. Recently, RFCA for atrial fibrillation has been pointed out as a cause of SMA syndrome, in which the ablation energy from RFCA is radiated outside the heart and damages the perigastric vagal plexus, resulting in gastric peristalsis, anorexia, and weight loss, which causes SMA syndrome. In the present case, the peri-SMA intestinal tract was observed with positional ultrasonography, which allowed real-time observation of the opening of the duodenal stenosis as the SMA was greatly displaced in the left lateral recumbent position. Ultrasonography utilizing positional changes is useful for diagnosis of SMA syndrome and identification of the optimal position for prevention of the onset of this syndrome.</p>
Journal
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- Choonpa Igaku
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Choonpa Igaku 50 (2), 137-141, 2023
The Japan Society of Ultrasonics in Medicine
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Details 詳細情報について
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- CRID
- 1390013939099902080
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- ISSN
- 18819311
- 13461176
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- Text Lang
- ja
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- Data Source
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- JaLC
- Crossref
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- Abstract License Flag
- Disallowed