title: Laparoscopic Ladd's procedure for superior mesenteric artery syndrome.
abstract: Superior mesenteric artery (SMA) syndrome is an uncommon condition where the third portion of the duodenum is compressed and obstructed between the SMA and the aorta. An otherwise healthy 17-year-old female presented with a 2-month history of postprandial abdominal pain and weight loss. Upper gastrointestinal (UGI) series demonstrated SMA obstruction of the third portion of the duodenum. Despite nasojejunal tube feedings over 4months with appropriate weight gain, symptoms continued and repeat UGI demonstrated persistent SMA syndrome. A laparoscopic Ladd's procedure served as definitive treatment. The steps of the procedure include mobilization of the Ligament of Treitz, mobilization of the right colon, complete derotation of the duodenum, delivery of the small bowel to the right upper quadrant, and appendectomy. Following the procedure, a postoperative UGI showed complete resolution of SMA compression of the duodenum. The patient had an uneventful postoperative course with immediate resolution of symptoms. She was discharged home tolerating a regular diet.
authors.affiliation: Division of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Alsulaimy
authors.affiliation: Division of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA.
authors.forename: Jun
authors.initials: J
authors.lastname: Tashiro
authors.affiliation: Division of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA.
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: Perez
authors.affiliation: Division of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA. Electronic address: jsola@med.miami.edu.
authors.forename: Juan E
authors.initials: JE
authors.lastname: Sola
mesh_terms: D000293:Adolescent; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy; D011859:Radiography; D013478:Superior Mesenteric Artery Syndrome / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Adolescent; Laparoscopy; Superior mesenteric artery syndrome