The Superior Mesenteric Artery Syndrome: A Rare Complication after Post-Traumatic Spine Surgery

Main Article Content

Mounir Bouali
El Batloussi Yousra
Abdelillah El Bakouri
Fatimazahra Bensardi
Khalid El Hattabi
Abdelaziz Fadil

Abstract

Superior mesenteric artery syndrome is a rare complication of post-traumatic spine surgery. The third portion of the duodenum is compressed between the abdominal aorta and the superior mesenteric artery: duodenal (intestinal) occlusion and sometimes arterio-mesenteric occlusion occur. We report the case of a young male patient, in whom this syndrome occurred after spinal surgery. He had fractures in the dorso-lumbar vertebrae. The patient had undergone an osteosynthesis. On a post-operative day 3, he had vomiting. Abdominal CT revealed the findings indicative of superior mesenteric artery syndrome: gastric dilatation and complete halt of the third part of the duodenum. We chose conservative treatment: the rest of the digestive tract, early parenteral nutrition, and correction of fluid and electrolyte imbalances. These treatments did not ameliorate the condition and thus we performed laparotomic gastro-jejunal bypass, which completely ameliorated the condition. The patient was discharged on the 7 postoperative day. We here summarize the clinical features and treatment fundamentals of this disorder.  

Keywords:
Superior mesenteric artery, duodenal obstruction, post traumatic spin surgery

Article Details

How to Cite
Bouali, M., Yousra, E. B., Bakouri, A. E., Bensardi, F., Hattabi, K. E., & Fadil, A. (2020). The Superior Mesenteric Artery Syndrome: A Rare Complication after Post-Traumatic Spine Surgery. International Research Journal of Gastroenterology and Hepatology, 3(2), 34-38. Retrieved from http://journalirjgh.com/index.php/IRJGH/article/view/30117
Section
Case Report

References

Welsch T, Büchler MW, Kienle P. Recalling superior mesenteric artery syndrome. Digestive Surgery. 2007;24(3):149-56.

Von Rokitansky CA. Handbook der Pathologischen Anatomic. 1st ed. Vienna: Wren, Braumuller and Seidel; 1842.

Stavely AL. Acute and chronic gastromesenteric ileus with cure in a chronic case by duodenojejunostomy. Bull John Hopkins Hosp. 1908;19:252.

Traore MM, Leye PA, Bah MD, et al. Early form of Wilkie's syndrome: A rare complication of scoliosis surgery, about a case and review of the literature. The Pan African Medical Journal. 2016;25:90.

Salem A, Al Ozaibi L, Nassif SM, Osman RA, Al Abed NM, Badri FM. Superior mesenteric artery syndrome: A diagnosis to be kept in mind (Case report and literature review). Int J Surg Case Rep. 2017;34:84-6.

Mansberger AR Jr., Hearn JB, Byers RM, Fleisig N, Buxton RW. Vascular compression of the duodenum. Emphasis on accurate diagnosis. Am J Sung. 1968; 115:89-96.

Zadegan F, Lenoir T, Drain O, et al. Syndrome de la pince aorto-mésentérique après correction d'une déformation rachidienne: À propos d’un cas et revue de la literature. Rev Chir Orthop Réparatrice Appar Mot. 2007;93(2):181-5.

Tsirikos AI, Anakwe RE, Baker ADL. Late presentation of superior mesenteric artery syndrome following scoliosis surgery: A case report. J Med Case Reports. 2008; 2:9.

Shah MA, Albright MB, Vogt MT, Moreland MS. Superior mesentericartery syndrome in scoliosis surgery: Weight percentile for height as an indicator of risk. J Pediatr Orthop. 2003;23(5):665-66.

Ooi GC, Chan KL, Ko KF, Peh WE. Computed tomography of the superior mesenteric artery syndrome. Clin Imaging. 1997;21(3):210-212.

Fall M et al. Le syndrome de la pince aorto-mésentérique chez l’enfant: A propos d’un cas primitif. Pan Afr Med J. 2014;19: 151.

Welsh T, Bùchler MW, Kienle P. recalling superior mesenteric artery syndrome. Dig Surg. 2007;24:149-56.

Loeb T, Loubert G, Morsly R, Gabillet JM, Pasteyer J. Syndrome de l'artère mésentérique supérieure. Ann Fr Anesth Réanim. 1999;18(9):1000-4.

Kadji M, Naouri A, Bernard P. Syndrome de la pince aorto-mésentérique: A propos d'un cas. Ann de chir. 2006;131(6-7):389-392.

Walker C, Kahanovitz N. Recurrent superior mesenteric artery syndrome complicating staged reconstructive spinal surgery: Alternative methods of conser-vative treatement. J Pediatr Orthop. 1993;3 (1):77-80.

Adson DE, Mitchell JE, Trenkner SW. The superior mesenteric artery syndrome and acute gastric dilatation in eating disorders: A report of two cases and a review of literature. Int J Eat Disord. 1997;21(2):103-114.

Hutchinson DT, Bassett GS. Superior mesentericartery syndrome in pediatricorthopedic patients. Clin Orthop. 1990;(250):250-7.

Pottorf BJ, Husain FA, Hollis HW Jr, Lin E. Laparoscopic management of duodenal obstruction resulting from superior mesenteric artery syndrome. JAMA Surg. 2014;149(12):1319–22.

Sun Z, Rodriguez J, McMichael J, Walsh RM, Chalikonda S, Rosenthal RJ, et al. Minimally invasive duodenojejunostomy for superior mesenteric artery syndrome: A case series and review of the literature. Surg Endosc. 2015;29(5):1137–44.

Shinji S, Matsumoto S, Kan H, Fujita I, Kanazawa Y, Yamada T, et al. Superior mesenteric artery syndrome treated with singleincision laparoscopy-assisted duodenojejunostomy. Asian J Endosc Surg. 2015;8(1):67–70.

Kirby GC, Faulconer ER, Robinson SJ, Perry A, Downing R. Superior mesenteric artery syndrome: A single centre experience of laparoscopic duodenojejunostomy as the operation of choice. Ann R Coll Surg Engl. 2017;99(6): 472–5.

Wilkie D. Chronic duodenal ileus. Am J Med Sci. 1927;173(5):643–8.

Sun Z, Rodriguez J, McMichael J, Walsh RM, Chalikonda S, Rosenthal RJ, et al. Minimallyinvasive duodenojejunostomy for superior mesenteric artery syndrome: A case series and review of the literature. Surg Endosc. 2015;29(5):1137–44.