title: [Early form of Wilkie's syndrome: a rare complication of scoliosis surgery, about a case and review of the literature].
abstract: Superior mesenteric artery syndrome is a rare complication occurring after surgical treatment for scoliosis. Surgical correction of the scoliotic spine produces vertical traction on the mesenteric artery and the narrowing of the aortomesenteric angle, hence the compression of the third part of the duodenum causing the syndrome. We here report the case of a young girl with an early form of superior mesenteric artery syndrome secondary to surgical correction of idiopathic scoliosis. The patient underwent posterior spinal fusion for idiopathic scoliosis. On the third postoperative day she experienced uncontrollable vomiting associated with no evacuation of faeces and no passing of flatus. Urgent abdominal CT scan was performed which allowed the diagnosis of superior mesenteric artery syndrome. Treatment consisted in the rest of the digestive tract associated with early parenteral nutrition and correction of fluid and electrolyte imbalances. Lacking evidence of clinical improvement, surgical indication was posed. The evolution was favourable with an uneventful postoperative recovery and the resumption of adequate food intake on the fourth postoperative day. The patient was discharged on the seventh postoperative day. Contributing factors are young age, long-limbed morphotype with BMI below 18. CT scan shows an important gastric dilatation associated with complete halt of the third part of the duodenum. The treatment is multidisciplinary, medical (first-line treatment) and surgical (if medical treatment do not help). A better knowledge of the predictors of medical treatment failure would reduce the length of hospital stay.
authors.affiliation: Centre Hospitalier de l'Ordre de Malte à Dakar, Sénégal.
authors.forename: Mamadou Mour
authors.initials: MM
authors.lastname: Traore
authors.affiliation: Service d'Anesthésie - Réanimation CHU Aristide Le Dantec à Dakar, Sénégal.
authors.forename: Pape Alassane
authors.initials: PA
authors.lastname: Leye
authors.affiliation: Département d'Anesthésie - Réanimation CHU Fann à Dakar, Sénégal.
authors.forename: Mamadou Diawo
authors.initials: MD
authors.lastname: Bah
authors.affiliation: Centre Hospitalier de l'Ordre de Malte à Dakar, Sénégal.
authors.forename: Charles Valérie Alain
authors.initials: CV
authors.lastname: Kinkpe
authors.affiliation: Service d'Anesthésie - Réanimation CHU Aristide Le Dantec à Dakar, Sénégal.
authors.forename: Pape Ibrahima
authors.initials: PI
authors.lastname: Ndiaye
authors.affiliation: Centre Hospitalier de l'Ordre de Malte à Dakar, Sénégal.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Daffe
authors.affiliation: Service de Chirurgie Générale CHU Aristide Le Dantec à Dakar, Sénégal.
authors.forename: Alpha Omar
authors.initials: AO
authors.lastname: Toure
authors.affiliation: Département d'Anesthésie-Réanimation CHU Fann à Dakar, Sénégal.
authors.forename: Oumar
authors.initials: O
authors.lastname: Kane
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D011183:Postoperative Complications / Q000503:physiopathology; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects* / Q000379:methods; D013478:Superior Mesenteric Artery Syndrome / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D014057:Tomography, X-Ray Computed / Q000379:methods; D014839:Vomiting / Q000209:etiology
keywords: Superior mesenteric artery; duodenal obstruction; idiopathic scoliosis