Laparoscopic duodenojejunostomy for the treatment of superior mesenteric artery (SMA) syndrome: case series

R Wyten, CJ Kelty, GL Falk - Journal of Laparoendoscopic & …, 2010 - liebertpub.com
R Wyten, CJ Kelty, GL Falk
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2010liebertpub.com
Superior mesenteric artery (SMA) syndrome is an atypical, rare cause of both acute and
chronic high intestinal obstruction. Identification of this syndrome can be a diagnostic
dilemma and is frequently made by exclusion. The most characteristic symptoms are
postprandial epigastric pain, eructation, fullness, and voluminous vomiting. Symptoms are
caused by compression of the third portion of the duodenum against the posterior structures
by a narrow-angled SMA. When nonsurgical management is not possible or the problem is …
Abstract
Superior mesenteric artery (SMA) syndrome is an atypical, rare cause of both acute and chronic high intestinal obstruction. Identification of this syndrome can be a diagnostic dilemma and is frequently made by exclusion. The most characteristic symptoms are postprandial epigastric pain, eructation, fullness, and voluminous vomiting. Symptoms are caused by compression of the third portion of the duodenum against the posterior structures by a narrow-angled SMA. When nonsurgical management is not possible or the problem is refractory, surgical intervention is necessary. In this article, we report a case series of SMA syndrome in 3 patients with radiologic evaluation confirming compression of the third portion of the duodenum by the SMA with resultant proximal dilatation. The patients all successfully underwent laparoscopic duodenojejunal anastomosis.
Mary Ann Liebert
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