Willkies syndrome

[Amy]

Hello,
Just a bit of history for you; I had my initial spinal fusion when I was 12 years of age over two operations (anterior/posterior) and then a third operation when I was 16 (lumber scoliosis continued to increase and I had breakage of the initial implants). I am now fused from T2 to L4. I am currently working as a Registered Nurse and am pain free and healthy otherwise. I am keeping as fit as possible, I swim every week and do personal training three times a week plus walking and regular physiotherapy.
Recently, I have been diagnosed with Mesenteric Artery Syndrome (Willkie’s Syndrome) and with an incisional hernia, My right kidney also sits near this hernia. My gastroenterologist has opted for conservative management at this stage, although I still have to visit an ED every few months with a small bowel obstruction which eventually resolves. Is this because of my scoliosis? Do you have any information/resources of advice that might be helpful for me? Does Willkie’s syndrome pose a problem for pregnancy? I am thinking about getting a second opinion. Have you heard of many patients with this?
Any help would be great,
Thankyou kindly.

[Dr Scoliosis]

Thank you for your enquiry.

The eponymous name of mesenteric artery syndrome is Wilkie's syndrome.

There are many causes of this syndrome, some of which are well understood and some which are not. Perhaps the most frequently studied form of the syndrome is when for whatever reason there is a profound loss of weight and the supporting tissue around the artery near its origin from the aorta, the main arterial trunk in the abdomen, is depleted and this is evidenced by loss of fatty tissue.

The syndrome is sometimes seen in patients following posterior spinal procedures for scoliosis where rods have been employed. The Dr Scoliosis on duty saw it a number of times over 30 odd years and most of the patients were very tall and thin.

If you have lost a lot of weight that may be associated with the onset of symptoms and as you are seeing a gastroenterologist presumably he has done a CT scan which is one way to demonstrate what is astray.

Inasmuch as you had an anterior procedure the incision in your loin will be not far from your right kidney but this is not a matter for concern. An incisional hernia is a rare sequel to anterior approaches for scoliosis correction when access to the spine is gained by a loin incision.

I think it is fair to say that there is no relation between your scoliosis and the mesenteric artery syndrome and I am unaware of any link between the syndrome and childbearing.

On a slightly different matter, I am somewhat concerned in general terms that with two mobile discs, that is, L4-5 and L5/S1, you are working as a registered nurse. There are few more stressful occupations than practical nursing and the incidence of "back problems" in nurses is very high. You might consider putting your knowledge and expertise into an area in a profession which would not put your lumbar spine at risk. It is all well and good when you are young and fit and you are to be commended for the actions that you are taking in this regard but as time goes by there are other considerations to take into account. You should discuss this matter with the surgeon who looked after your scoliosis.

I trust this information is helpful.