title: Late-onset superior mesenteric artery syndrome four years following scoliosis surgery - a case report.
abstract: BACKGROUND
  Superior mesenteric artery (SMA) syndrome has been reported as an uncommon condition of external vascular compression of the SMA particularly after rapid weight loss, body casts, or after corrective surgery for spinal deformities, usually within the first few weeks after surgery.
  
  
  METHODS
  This is a retrospective report of a case of a non-verbal autistic female patient who started to develop SMA syndrome at the age of 16, 4 years after posterior spinal fusion surgery for scoliosis. She was treated conservatively by increasing oral caloric intake, which resulted in increased body weight and relief of symptoms.
  
  
  RESULTS
  Seen at 10 years' follow up, the patient is doing well, and is functional within the limits of her suboptimal cognitive and verbal conditions. She maintains good trunk balance with solid spinal fusion and intact instrumentation at latest follow up.
  
  
  CONCLUSIONS
  Spinal surgeons should maintain a high index of suspicion for diagnosis of SMA syndrome even years after scoliosis surgery, especially for patients with communication problems, like the case we present here. Appropriate conservative measures can succeed in relieving the symptoms, increasing body weight, and preventing complications including the risk of death.
authors.affiliation: Department of Orthopaedic Surgery, Assiut University Hospital Assiut 71526 Egypt ; Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia 3401 Civic Center Boulevard Philadelphia PA 19104 USA.
authors.forename: Nariman
authors.initials: N
authors.lastname: Abol Oyoun
authors.affiliation: Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia 3401 Civic Center Boulevard Philadelphia PA 19104 USA.
authors.forename: Muayad
authors.initials: M
authors.lastname: Kadhim
authors.affiliation: Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia 3401 Civic Center Boulevard Philadelphia PA 19104 USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Dormans
keywords: SMA Syndrome; Scoliosis; Spinal fusion; Superior Mesenteric Artery