What is probable diagnosis of a pt. with spinal POP cast presenting with bilious vomitting ?

Ans is (b) Duodenal obstruction This is a patient with superior mesenteric syndrome or 'Wilkie's Syndrome' the superior mesenteric aery compresses the 3rd poion of the duodenum as it passes over it. Superior mesenteric Aery arises from the Ant. aspect of Aoa, passes behind the neck of pancreas but in front of the uncinate process and crosses in front of the 3rd poion of the duodenum to enter the root of mesentery. The acute angle at which the superior mesenteric aery arises from the Aoa may compress the transverse poion of the duodenum between it and Aoa causing paial intestinal Strutil Out obstruction, a condition referred to as superior mesenteric aery compression syndrome. Predisposing conditions:? (1) Placement of body cast (sometines called cast (3) Scoliosis syndrome) (2) Weight loss (3) Supine immobilization Clinical features - Sympotoms of Duodenal obstruction (depending upon severity of obstruction) Diagnosis - By Barium upper G.I. series or Hypotonic duodenography Treatment - Initially conservative - Operative t/t of choice - Duodenojejunostomy*