[A case report of superior mesenteric artery syndrome after hand-assisted laparoscopic left nephrectomy].
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.
Kanemitsu
Toshiyuki
T
Department of Urology, Sumitomo Hospital.
Saito
Jun
J
Satoh
Mototaka
M
Mori
Naoki
N
Sekii
Kenichiro
K
Yoshioka
Toshiaki
T
Itatani
Hiroaki
H
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*