CHRONIC DUODENAL ILEUS (WILKIE’S SYNDROME)
It is also called as superior mesenteric artery (SMA) syndrome. It is due to obstruction of the 3rd part of the duodenum due to decreased angle between SMA and aorta.
There will be narrowing of aortomesenteric angle, becoming less than 15.2°; aortomesenteric distance becoming less than ,10 mm with abnormally low origin of SMA.
It can be congenital or due to low insertion of SMA or high insertion of duodenal end or due to traumatic aneurysm of SMA.It can be aggravated by plaster casts, lordosis, pancreatic tumour, enlarged lymph node in the 3rd part of duodenum (Cast syndrome).