title: Laparoscopic gastrojejunostomy for superior mesenteric artery syndrome in a patient with Parkinson's disease.
abstract: BACKGROUND
  Superior mesenteric artery syndrome is rare cause of intestinal obstruction. We report an unusual case of a patient with Parkinson's disease who developed superior mesenteric artery syndrome and discuss her management including laparoscopic gastrojejunostomy and Roux-en-Y anastomosis.
  
  
  METHODS
  A 78-year-old patient with advanced Parkinson's disease presented with significant malnutrition, vomiting and post-prandial abdominal pain. Computed tomography confirmed duodenal compression by the superior mesenteric artery. We hypothesised this was likely triggered by extreme weight loss associated with advanced Parkinson's disease. As the patient failed to improve with conservative measures, laparoscopic gastrojejunostomy and Roux-en-Y anastomosis was successfully performed without complications and the patient discharged on day 7.
  
  
  CONCLUSIONS
  Successful treatment was achieved due to early recognition of the consequences of chronic illness and addressing malnutrition. From this experience, we propose that laparoscopic gastric bypass is a safe and minimally invasive effective treatment option for superior mesenteric artery syndrome.
authors.affiliation: Research Fellow Bariatric Surgery, Department of Surgery, University Hospital Ayr, Ayr, Scotland.
authors.forename: A
authors.initials: A
authors.lastname: Chung
authors.affiliation: Specialty Training Doctor, Department of Surgery, University Hospital Ayr, Ayr, Scotland.
authors.forename: L I
authors.initials: LI
authors.lastname: Smith
authors.affiliation: Specialty Training Doctor, Department of Surgery, University Hospital Ayr, Ayr, Scotland.
authors.forename: Ael
authors.initials: A
authors.lastname: McMurran
authors.affiliation: Consultant General & Upper GI Surgeon, Department of Surgery, University Hospital Ayr, Ayr, Scotland Abdulmajid.Ali@aaaht.scot.nhs.uk.
authors.forename: A
authors.initials: A
authors.lastname: Ali
mesh_terms: D000368:Aged; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D010535:Laparoscopy / Q000379:methods*; D010300:Parkinson Disease / Q000150:complications; D013478:Superior Mesenteric Artery Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Laparoscopic gastrojejunostomy; Parkinson’s disease; superior mesenteric artery syndrome