Supplementary Material for: Superior Mesenteric Artery Syndrome Improved by Enteral Nutritional Therapy: A Retrospective Case-Series Study in a Single Institution

Introduction: Superior mesenteric artery syndrome (SMAS) is a relatively rare cause of chronic duodenal obstruction, owing to the compression of the third portion of the duodenum. Objectives: This retrospective study aims to discuss the efficacy of enteral nutrition (EN) therapy in nutritional status and symptom improvement at a short-term follow-up for SMAS patients. Methods: We retrospectively analyzed clinical data of patients diagnosed as SMAS and treated with EN from September 2012 to January 2019. Results: Twenty-six patients were included (16 women; mean age 24.96 ± 11.77 years), none was excluded, and one was lost to follow-up. The patients’ mean body weight was 40.94 ± 10.16 kg, mean weight loss 11.73 ± 7.58 kg, and mean body mass index (BMI) 14.82 ± 2.52 kg/m2. The mean duration of EN therapy was 10.10 ± 4.66 months. Serum level of nutritional indicators, BMI and body weight increased after EN therapy. During a median follow-up of 24 months (9–44) after EN therapy, the mean symptom score decreased from 24.28 ± 9.57 to 8.06 ± 8.29 (p < 0.0001), and 65% of patients’ symptoms resolved and 15% of patients’ symptoms improved. In total, 16 complications occurred, including tube blockage, peristomal wound infections, peristomal leakage, granulomas, and nasopharyngeal pain. Conclusion: EN therapy may be an effective option for SMAS patients. While it might not remove all symptoms, it can improve the nutritional status to support subsequent treatments.

引言：肠系膜上动脉综合征（Superior mesenteric artery syndrome, SMAS）是一类相对罕见的慢性十二指肠梗阻病因，其发病机制为十二指肠第三段受压迫。研究目的：本回顾性研究旨在探讨肠内营养（enteral nutrition, EN）疗法在短期随访中对SMAS患者营养状态及症状改善的疗效。研究方法：我们回顾性分析了2012年9月至2019年1月期间确诊为SMAS并接受EN治疗的患者临床资料。研究结果：共纳入26例患者（女性16例；平均年龄24.96±11.77岁），无患者被排除，1例失访。患者平均体重为40.94±10.16 kg，平均体重丢失量为11.73±7.58 kg，平均体重指数（body mass index, BMI）为14.82±2.52 kg/m²。EN治疗的平均持续时长为10.10±4.66个月。EN治疗后，患者的营养指标血清水平、BMI及体重均有所升高。在EN治疗后的中位随访24个月（范围9~44个月）期间，患者的平均症状评分从24.28±9.57降至8.06±8.29（p<0.0001），65%的患者症状完全缓解，15%的患者症状得到改善。共发生16例并发症，包括管道堵塞、造口周围伤口感染、造口周围渗漏、肉芽肿形成及鼻咽部疼痛。研究结论：EN疗法可作为SMAS患者的有效治疗选择。尽管其可能无法完全消除所有症状，但可改善患者营养状态，为后续治疗提供支持。