Superior Mesenteric Artery Syndrome: Author’s Point of View

  • Romeo BardiniEmail author
Letter to Editor

Dear Editor,

In his letter about our study [ 1], Dr. Levin’s letter stated that “all the mistakes of previous researchers and my group brought to the point of the absurdity.” We disagree with him. Professor von Rokitansky first described the superior mesenteric artery syndrome (SMAS) as duodenal ileum in 1842 and several cases in the international literature have been described along the years. Moreover, during my career, I have personally observed hundreds of patients with different upper gastrointestinal tract transit abnormalities trying to understand which was the underlying disease and how to offer a solution to their problem. Several points of Dr. Levin’s letter need a reply:
  1. 1.

    Dr. Levin states that the aortomesenteric angle < 22° and distance < 8 mm cannot be considered as the gold standard because “low body weight is not a determining factor in the pathogenesis of the SMAS” as demonstrated also by the fact that “in the third-world countries, there are hundreds of millions of...


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Conflict of interest

The author declares no conflict of interest.


  1. 1.
    Ganss A, Rampado S, Savarino E, Bardini R. Superior Mesenteric Artery Syndrome: a Prospective Study in a Single Institution. J Gastrointest Surg. 2019 May;23(5):997-1005. doi: Scholar
  2. 2.
    Albot G, Kapandji M, Ringenbach J. Physiopathology of timed duodenal intubation. II. Role of Ochsner’s sphincter in the mechanism of normal duodenal intubation and in that of certain prolongations of so-called Oddi’s closed time. Arch Mal Appar Dig Mal Nutr. 1956 Dec;45(12):449-57.PubMedGoogle Scholar

Copyright information

© The Society for Surgery of the Alimentary Tract 2019

Authors and Affiliations

  1. 1.General Surgery UnitAzienda Ospedaliera di PadovaPadovaItaly

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