Search

Aorto-mesenteric compression of the duodenum (Wilkie syndrome, upper mesenteric artery syndrome) is one of the causes of chronic duodenal obstruction. This condition is caused by compression of the horizontal branch of the duodenum between the abdominal aorta and the superior mesenteric artery, departing from the aorta at an acute angle. Among the causes of this pathological condition, an asthenic physique, pronounced weight loss in a short period of time, and others are distinguished. Currently, the main component of eliminating aorto-mesenteric compression is surgical intervention. Among other surgical methods, the most optimal is duodeno-jejunostomy according to AlbrechtStaveley. However, when this surgical intervention is associated with a high risk of developing a vicious circle syndrome. The developed modification of the AlbrechtStaveley operation aims to minimize the risks of developing the vicious circle syndrome.

Introduction Superior mesenteric artery syndrome is a rare condition characterised by nausea, vomiting, postprandial pain, anorexia and early satiety. Conservative management is tried initially, but if this fails, surgery is indicated. There are few reports in the literature concerning superior mesenteric artery syndrome in children, and fewer still managed surgically by minimally invasive means. Case presentation A 12-year-old girl presented with weight loss, early satiety and vomiting after corrective scoliosis surgery. After upper gastrointestinal endoscopy, contrast study and computed tomography imaging, a diagnosis of superior mesenteric artery syndrome was made. Conservative management by nasojejunal feeding failed; therefore, a laparoscopic duodeno-jejunostomy was undertaken. At follow-up, her symptoms had improved. Conclusion This report describes the youngest child to undergo laparoscopic duodeno-jejunostomy for superior mesenteric artery syndrome. Laparoscopic duodeno-jejunostomy appears to be the most widely employed and reliable minimally invasive approach to superior mesenteric artery syndrome with a high success rate and acceptably low complication rate.

Background. Duodenum inversum is an often unrecognized anomaly of duodenal rotation/fixation at upper gastrointestinal (UGI) contrast study because the duodenojejunal junction appears normally located. Objective. This anomaly is important to diagnose because it may result in obstructive gastrointestinal symptoms. Conclusion. We describe a case of duodenum inversum mimicking superior mesenteric artery (SMA) syndrome that improved after surgical therapy.

The Superior Mesenteric Syndrome is a rare and controversial disease. The compression of the duodenum by the mesenteric artery and aorta causes an intermitent obstruction. Preoperative diagnosis is very difficult.We present one case of this syndrome in a pacient with severe weight loss and signs of high intestinal obstruction. The diagnosis was based on clinical and radiologic findings. A duodenojejunostomy was performed after medical treatment failure.This patient died on the 20th posoperative day due to cardiac complications. This syndrome must be remembered in cases of high obstruction in chronic ill patients.

A case where duodenal obstruction complicated elective repair of abdominal aortic aneurysm is reported. A review of the literature shows that the incidence of this rare complication has probably been underestimated. Patients should be treated expectantly, regardless of the pathogenesis of the obstruction.

This report emphasizes a potentially dangerous complication in the form of acute bowel obstruction which may confront the orthopedic surgeon as a diagnostic problem. The anatomic architecture incriminated in producing this syndrome is reviewed. The clinical criteria suggesting the diagnosis are not pathognomonic and may be misleading. Roentgenography with barium swallow is the most consistent and helpful diagnostic aid. Conservative therapy is usually successful, but duodenojejunostomy may become necessary if the conservative regimen fails. Four cases are presented in which the syndrome occurred as a complication of orthopedic treatment. The treatment of the mesenteric artery syndrome may modify the intended orthopedic regimen. It is suggested from these cases that the cast syndrome may indeed occur without a cast.

A brief review of the superior mesenteric artery syndrome is given. A case is reported which occurred after 9 weeks of treatment of a fractured femur by continuous traction with balanced suspension. The condition was successfully treated by conservative measures including a plaster hip spica allowing frequent changes of position. The importance of early diagnosis and prompt treatment is emphasized.