Superior mesenteric artery syndrome as a complication in hip spica application for immobilization: report of a case.
A 10-year-old girl who had a pelvic and femoral osteotomy for congenital dislocation of her right hip was immobilized with a hip spica. On the 28th postoperative day, she had upper abdominal pain, distention and bilious vomiting. An upper GI series demonstrated complete obstruction of the duodenum at the third portion of the duodenum in a supine position; however, the barium passed the obstruction site slowly when the patient assumed a lateral or prone position. She was successfully treated conservatively with nasogastric decompression, fluid replacement, proper positioning and hyperalimentation. Superior mesenteric artery syndrome is a rare complication in patients immobilized in a body cast or hip spica. Early diagnosis and proper treatment usually leads to an uneventful convalescence.
Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, R.O.C.
S H
SH
Chen
W S
WS
Chen
J H
JH
Chuang
D001466:Barium Sulfate; D002370:Casts, Surgical / Q000009:adverse effects*; D002648:Child; D005260:Female; D006618:Hip Dislocation, Congenital / Q000601:surgery*; D006801:Humans; D007870:Leg Length Inequality / Q000601:surgery*; D010027:Osteotomy; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D011859:Radiography; D013478:Superior Mesenteric Artery Syndrome / Q000000981:diagnostic imaging / Q000209:etiology*
D001466:Barium Sulfate