Laparoscopic duodenojejunostomy for superior mesenteric artery syndrome.
BACKGROUND
Superior mesenteric artery (SMA) syndrome, also called Wilkie's syndrome, is a rare clinical phenomenon believed to be caused by compression of the third portion of the duodenum by the overlying superior mesenteric artery. We present the case of a 32-year-old female who presented with epigastric pain, weight loss, and vomiting.


METHODS
Her workup included a normal upper endoscopy as well as an abdominal CT scan and upper GI contrast study that confirmed the diagnosis of superior mesenteric artery syndrome. The patient was taken to the operating room and underwent successful treatment with laparoscopic duodenojejunostomy.


RESULTS
The patient achieved complete relief of her symptoms and is able to eat a regular diet without difficulty. SMA syndrome is a real anatomic clinical pathology resulting in chronic, consistent obstructive symptoms. An upper GI series and CT scan with contrast can confirm the diagnosis.


CONCLUSIONS
Laparoscopic duodenojejunostomy should be considered the treatment of choice for these patients, because it offers a high likelihood of excellent outcome based on the current literature.
Fraser
Jason D
JD
Department of General Surgery, Mayo Clinic Arizona, Phoenix Arizona 85032, USA. fraser.jason@mayo.edu
St Peter
Shawn D
SD
Hughes
Jenevieve H
JH
Swain
James M
JM
D000328:Adult; D004385:Duodenostomy / Q000379:methods*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007582:Jejunostomy / Q000379:methods*; D010535:Laparoscopy; D013478:Superior Mesenteric Artery Syndrome / Q000601:surgery*; D013536:Suture Techniques