title: [A case report of superior mesenteric artery syndrome after hand-assisted laparoscopic left nephrectomy].
abstract: A 65-year-old man with left renal cell carcinoma RCC underwent hand-assisted laparoscopic nephrectomy. He was discharged on the 8th hospital day, but 2 days later he was admitted to the hospital again because of vomiting and abdominal pain. Abdominal computed tomography (CT) showed a narrow space between the superior mesenteric artery (SMA) and aorta as well as distension of the proximal duodenum. Upper gastrointestinal radiographic studies with gastrografin showed abrupt vertical cut-off sign of the third part of the duodenum. Therefore, we diagnosed SMA syndrome. We started conservative management by nasogastric tube and total parenteral nutrition through a central venous line. The patient was able to eat on day 24 and was discharged on day 34 after the treatment. SMA syndrome is considered as a postoperative complication after abdominal surgery, but it is extremely rare. To our knowledge, only 4 cases of SMA syndrome following nephrectomy have been reported and this is the first case of SMA syndrome following laparoscopic nephrectomy.
authors.affiliation: Department of Urology, Sumitomo Hospital.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Kanemitsu
authors.forename: Jun
authors.initials: J
authors.lastname: Saito
authors.forename: Mototaka
authors.initials: M
authors.lastname: Satoh
authors.forename: Naoki
authors.initials: N
authors.lastname: Mori
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Sekii
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Yoshioka
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Itatani
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000601:surgery; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery; D010535:Laparoscopy; D008297:Male; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods*; D011183:Postoperative Complications; D013478:Superior Mesenteric Artery Syndrome / Q000209:etiology*