Superior Mesenteric Artery Syndrome: An Infrequent Complication of Scoliosis Surgery

Superior mesenteric artery syndrome is a rare condition that causes a proximal small intestinal obstruction due to contraction of the angle between the superior mesenteric artery and the aorta. Scoliosis surgery is one of the 15 reasons for superior mesenteric artery syndrome, which can present with acute or chronic manifestations. Although conservative treatment is usually possible, surgical treatment is required in certain cases that cannot be treated using conservative methods. In this paper, we describe a patient who developed superior mesenteric artery syndrome after scoliosis surgery and was treated with duodenojejunostomy due to failure and complications of conservative treatment.

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S2768 A Rare Case of Small Intestinal Obstruction From Superior Mesenteric Artery Syndrome (SMAS) in Patient With Systemic Sclerosis (SS)

The American Journal of Gastroenterology ◽

10.14309/01.ajg.0000713120.56409.56 ◽

2020 ◽

Vol 115 (1) ◽

pp. S1446-S1447

Author(s):

Yasir Saeed ◽

Mohammad Aldiabat ◽

Sulaiman Azeez ◽

Affaf Gul

Keyword(s):

Systemic Sclerosis ◽

Intestinal Obstruction ◽

Superior Mesenteric Artery ◽

Mesenteric Artery ◽

Rare Case ◽

Superior Mesenteric Artery Syndrome ◽

Small Intestinal Obstruction ◽

Small Intestinal

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Superior mesenteric artery syndrome

International Surgery Journal ◽

10.18203/2349-2902.isj20170881 ◽

2017 ◽

Vol 4 (3) ◽

pp. 1141

Author(s):

Vikrant Mohan Bhagvat ◽

Juily Vishwanath Aher ◽

Nimesh Shah

Keyword(s):

Surgical Treatment ◽

Superior Mesenteric Artery ◽

Mesenteric Artery ◽

Rare Condition ◽

Superior Mesenteric Artery Syndrome ◽

Rapid Loss ◽

Outflow Obstruction ◽

Loss Of Weight ◽

Transverse Portion

Superior mesenteric artery syndrome (SMAS) is a rare condition caused by compression of the transverse portion of the duodenum between the superior mesenteric artery (SMA) and the aorta, causing symptoms of duodenal outflow obstruction. We report a case of superior mesenteric artery syndrome in a 25-year-old female associated with rapid loss of weight and intermittent vomiting and resulting in severe duodenal compression that necessitated surgical treatment.

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Superior mesenteric artery syndrome following spinal deformity correction

Pediatric Traumatology Orthopaedics and Reconstructive Surgery ◽

10.17816/ptors74105-112 ◽

2020 ◽

Vol 7 (4) ◽

pp. 105-112

Author(s):

Angelina S. Strelnikova ◽

Aleksandr S. Kozyrev ◽

Sergei V. Vissarionov ◽

Kirill A. Kartavenko ◽

Vladislav V. Murashko

Keyword(s):

Body Weight ◽

Surgical Treatment ◽

Intestinal Obstruction ◽

Superior Mesenteric Artery ◽

Spinal Deformity ◽

Mesenteric Artery ◽

Conservative Therapy ◽

Superior Mesenteric Artery Syndrome ◽

Life Threatening

Background. Superior mesenteric artery syndrome is a rare pathological condition caused by an abnormal transposition of the superior mesenteric artery from the abdominal part of the aorta. It results in compression of the distal part of the duodenum between the aorta and the superior mesenteric artery. It is clinically manifested by signs of acute intestinal obstruction, including pain in the epigastric region, nausea, and profuse vomiting. In the absence of timely treatment, patients may experience electrolyte disturbance, severe nutritional deficiency, the risk of perforation of the stomach, aspiration pneumonia, bezoar formation, thromboembolism, and the development of other life-threatening complications that can lead to death. Case study. In the presented case study, superior mesenteric artery syndrome developed in a 17-year-old girl after surgical correction of a spinal deformity in the treatment of idiopathic scoliosis. This was due to postoperative loss of body weight, as well as a rapid change in the patients ratio of growth to body weight. Discussion. Significant clinical improvement was achieved as a result of an integrated approach to the treatment of this complication. However, despite the successful result from conservative therapy, the patient remains at risk of developing chronic duodenal obstruction of varying severity, which may require surgical treatment. Conclusion. With the untimely and incomplete treatment of superior mesenteric artery syndrome, the risk of developing chronic intestinal obstruction increases. Treatment of this complication begins with conservative therapy. In the absence of the effect of conservative therapy, and in the case of disease progression, the development of life-threatening conditions (such as bleeding and perforation) requires surgical treatment.

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Superior Mesenteric Artery Syndrome: A Worldwide Descriptive Study with Literature Review

International Journal of Medical Students ◽

10.5195/ijms.2016.151 ◽

2016 ◽

Vol 4 (2) ◽

pp. 50-54

Author(s):

Ruhidayati Awaludin ◽

Hazimah Ab Rahim ◽

Dg. Syazana Arivai ◽

Mostafa Refaie Elkeleny

Keyword(s):

Superior Mesenteric Artery ◽

Mesenteric Artery ◽

Rare Condition ◽

Superior Mesenteric Artery Syndrome ◽

Time Interval ◽

Presenting Symptoms ◽

Clinical Presentations ◽

Choice Of Treatment ◽

Long Term Follow Up ◽

Microsoft Office

Background: Superior mesenteric artery syndrome is best described as compression of the third part of duodenum by the superior mesenteric artery, resulting in obstruction. This rare condition has been studied for decades yet remains obscure. This study aimed to analyze different clinical presentations, diagnostic modalities, treatment approaches and outcomes of this condition. Methods: Thirty-five superior mesenteric artery syndrome cases were collected retrospectively from a Facebook group called “Superior Mesenteric Artery Syndrome Awareness & Support”. A questionnaire was designed using Google Forms to obtain the demographics, presenting symptoms, risk factors and co-morbidities, investigations, means of treatment and the outcomes. Data was entered into Microsoft Office Excel for statistical analysis. Results: The median age at diagnosis was 22 years. The median body mass index was 20.8 kg/m2. The median time interval from symptom onset to initial diagnosis was 22 months. The major presenting symptoms were abdominal pain (82.9%), nausea (77.1%), and vomiting (65.7%). Abdominal computed tomography scan with contrast (82.9%) was commonly used for confirmation of diagnosis. Thirteen cases (37.1%) were congenital. Thirty patients (85.7%) had received treatment. The overall management success was only 13.3%. Surgical management (34.3%) was the most commonly used regimen. Conclusion: Diagnosis of superior mesenteric artery syndrome is established after a thorough assessment of the clinical presentations and confirmed with suitable imaging modalities. The choice of treatment should be dependent on the causes and severity as different patients respond differently to therapy. Recurrence is possible in all patients, and a long-term follow up is thus required.

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Superior mesenteric artery syndrome: A rare complication of scoliosis corrective surgery

Journal of Orthopaedic Surgery ◽

10.1177/2309499020945014 ◽

2020 ◽

Vol 28 (3) ◽

pp. 230949902094501

Author(s):

Weng Hong Chung ◽

Amir Arif Anuar ◽

Keong Joo Lee ◽

Mohd Shahnaz Hasan ◽

Chee Kidd Chiu ◽

...

Keyword(s):

Conservative Treatment ◽

Early Diagnosis ◽

Superior Mesenteric Artery ◽

Mesenteric Artery ◽

Nutritional Support ◽

Rare Complication ◽

Scoliosis Surgery ◽

Key Factors ◽

Diagnosis And Management ◽

Sma Syndrome

Superior mesenteric artery (SMA) syndrome is a rare but serious complication following scoliosis surgery. Early diagnosis and management are key factors for successful conservative treatment to avoid the need for emergency laparotomies which causes higher morbidity or even mortality. We report two adolescent idiopathic scoliosis patients with Cobb angle of 49° and 132°, respectively, and low body mass index who presented with SMA syndrome following posterior spinal fusion from T2 to L3 and were treated successfully with conservative management. Abdominal radiographs showed distended gastric shadow. Computed tomography angiography of the abdomen showed decreased aortomesenteric angle and SMA-aorta distance. Both patients were treated successfully with conservative treatment which included three principles: gastric decompression with nasogastric tube, correction of electrolytes imbalance, and nutritional support with low volume, high calorie nutritional supplement. Both patients were started with small but frequent meals. Surgeries were not required in both cases. Early diagnosis and management are the key factors to successful treatment in SMA syndrome. Patients with SMA can be treated successfully with conservative treatment comprising of nasogastric decompression, electrolyte correction, and nutritional support with small but frequent meals.

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