Both transposition of the SMA and lysis of the duodenal suspensory muscle have the advantage that they do not involve the creation of an intestinal anastomosis.The possible persistence of symptoms after surgical bypass can be traced to the remaining prominence of reversed peristalsis in contrast to direct peristalsis, although the precipitating factor (the duodenal compression) has been bypassed or relieved. Reversed peristalsis has been shown to respond to duodenal circular drainage—a complex and invasive open surgical procedure originally implemented and performed in China.In some cases, SMA syndrome may occur alongside a serious, life-threatening condition such as cancer or AIDS. Even in these cases, though, treatment of the SMA syndrome can lead to a reduction in symptoms and an increased quality of life. Prognosis
Delay in the diagnosis of SMA syndrome can result in fatal catabolysis (advanced malnutrition), dehydration, electrolyte abnormalities, hypokalemia, acute gastric rupture or intestinal perforation (from prolonged mesenteric ischemia), gastric distention, spontaneous upper gastrointestinal bleeding, hypovolemic shock, and aspiration pneumonia. A 1-in-3 mortality rate for Superior Mesenteric Artery syndrome has been quoted by a small number of sources. However, after extensive research, original data establishing this mortality rate has not been found, indicating that the number is likely to be unreliable. While research establishing an official mortality rate may not exist, two recent studies of SMA syndrome patients, one published in 2006 looking at 22 cases and one in 2012 looking at 80 cases, show mortality rates of 0% and 6.3%, respectively.
History
Ancient Greece
Pederasty in ancient Greece was a socially acknowledged romantic relationship between an adult male (the erastes) and a younger male (the eromenos), usually in his teens. It was characteristic of the Archaic and Classical periods. The influence of pederasty on Greek culture of these periods was so pervasive that it has been called "the principal cultural model for free relationships between citizens. "Some scholars locate its origin in initiation ritual, particularly rites of passage on Crete, where it was associated with entrance into military life and the religion of Zeus. It has no formal existence in the Homeric epics, and seems to have developed in the late 7th century BC as an aspect of Greek homosocial culture, which was characterized also by athletic and artistic nudity, delayed marriage for aristocrats, symposia, and the social seclusion of women. Pederasty was both idealized and criticized in ancient literature and philosophy. The argument has recently been made that idealization was universal in the Archaic period; criticism began in Athens as part of the general Classical Athenian reassessment of Archaic culture.Scholars have debated the role or extent of pederasty, which is likely to have varied according to local custom and individual inclination. Athenian law, for instance, recognized both consent and age as factors in regulating sexual behavior.Enid Bloch argues that many Greek boys in these relationships may have been traumatized by knowing that they were violating social customs, since the "most shameful thing that could happen to any Greek male was penetration by another male."