Wilkie Syndrome Is a Rare and Not Frequently Considered Pathology: Report of 2 Cases With Favorable Evolution After Conservative Treatment

Abstract

Wilkie syndrome, or superior mesenteric artery syndrome, is a rare and not frequently considered complication in burn patients. This clinical entity is caused by compression of the third portion of the duodenum between the abdominal aorta and superior mesenteric artery, leading to duodenal obstruction. It can also be caused by a decrease in retroperitoneal fat in cases of severe malnutrition, as observed in patients with large burns. Here, we report 2 patients with large burns who presented with significant weight loss, accompanied by upper digestive intolerance, vomiting, large volumes of gastric residual, and abdominal pain. The fundamental study for its diagnosis was abdominal computed tomography with aortic angiography, which revealed a decreased angle between the aorta and the superior mesenteric artery. In our patients, treatment consisted of nutrition by nasojejunal catheter in 1 patient, with the other patient also receiving nasojejunal nutrition by catheter after a period of parenteral nutrition. Conservative treatment was successful in both cases, with no need for surgery.