Minimally invasive surgery for superior mesenteric artery syndrome:A case report

Superior mesenteric artery(SMA) syndrome is defined as a compression of the third portion of the duodenum by the abdominal aorta and the overlying SMA. SMA syndrome associated with anorexia nervosa has been recognized, mainly among young female patients. The excessive weight loss owing to the eating...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2015-12, Vol.21 (45), p.12970-12975
Main Authors: Yao, Si-Yuan, Mikami, Ryuichi, Mikami, Sakae
Format: Article
Language:English
Subjects:
Anorexia Nervosa - complications
artery
Case Report
Duodenostomy - methods
Female
Humans
Jejunostomy - methods
Laparoscopy
mesenteric
nervo
Superior
Superior Mesenteric Artery Syndrome - diagnosis
Superior Mesenteric Artery Syndrome - etiology
Superior Mesenteric Artery Syndrome - surgery
syndrome
Anorexia
Tomography, X-Ray Computed
Treatment Outcome
Young Adult
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Summary:Superior mesenteric artery(SMA) syndrome is defined as a compression of the third portion of the duodenum by the abdominal aorta and the overlying SMA. SMA syndrome associated with anorexia nervosa has been recognized, mainly among young female patients. The excessive weight loss owing to the eating disorder sometimes results in a reduced aorto-mesenteric angle and causes duodenal obstruction. Conservative treatment, including psychiatric and nutritional management, is recommended as initial therapy. If conservative treatment fails, surgery is often required. Currently, traditional open bypass surgery has been replaced by laparoscopic duodenojejunostomy as a curative surgical approach. However, single incision laparoscopic approach is rarely performed. A 20-yearold female patient with a diagnosis of anorexia nervosa and SMA syndrome was prepared for surgery after failed conservative management. As the patient had body image concerns, a single incision laparoscopic duodenojejunostomy was performed to achieve minimal scarring. As a result, good perioperative outcomes and cosmetic results were achieved. We show the first case of a young patient with SMA syndrome who was successfully treated by single incision laparoscopic duodenojejunostomy. This minimal invasive surgery would be beneficial for other patients with SMA syndrome associated with anorexia nervosa, in terms of both surgical and cosmetic outcomes.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v21.i45.12970