Laparoscopic gastrojejunostomy for superior mesenteric artery syndrome in a patient with Parkinson’s disease

• Published in: Scottish medical journal 2016-02, Vol.61 (1), p.51-55
• Main Authors: Chung, A, Smith, LI, McMurran, AEL, Ali, A
• Format: Article
• Language: English
• Subjects: Aged; Female; Gastric Bypass - methods; Humans; Intestinal Obstruction - etiology; Laparoscopy - methods; Parkinson Disease - complications; Superior Mesenteric Artery Syndrome - complications; Superior Mesenteric Artery Syndrome - diagnostic imaging; Superior Mesenteric Artery Syndrome - surgery; Tomography, X-Ray Computed; Treatment Outcome
• ISSN: 0036-9330; 2045-6441
• DOI: 10.1177/0036933015619290

Introduction 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. Case presentation 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. Conclusion 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.