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To the Editor: We wish to compliment correspondents Barnes and Gwinn on their cautious approach to the management of abdominal pain in children.
Their comments avoid two areas of discussion. In what way would our surgical cases have been cared for in their hands? Detailed description and long-term follow-up by clinical and radiographic study of their cases is not provided.
It would be important for someone to demonstrate whether patients have continued symptoms and to compare the results of varying surgical procedures for the SMAS with our recommended treatment.
The function of the distal duodenum is not well understood. Our cineroentgenographic findings and postoperative results support the evidence of obstruction in this area. We agree that other documented studies are needed.
Some of our patients also had other preoperative findings: seasonal asthma, kyphoscoliosis, and school phobia for example. We have seen the development of duodenal ulcer in both untreated and
HYDE JS, NICHOLAS EE. SUPERIOR MESENTERIC ARTERY SYNDROME. Am J Dis Child. 1964;107(3):318. doi:10.1001/archpedi.1964.02080060319021