Minimally invasive surgery for superior mesenteric artery syndrome: a case report and literature review

Abstract

This report describes the youngest child to undergo laparoscopic duodeno-jejunostomy for superior mesenteric artery syndrome. Laparoscopic duodeno-jejunostomy appears to be the most widely employed and reliable minimally invasive approach to superior mesenteric artery syndrome with a high success rate and acceptably low complication rate.

Laparoscopic options in superior mesenteric artery syndrome in children: systematic review

“…The literature search revealed 702 papers, with 12 studies meeting the inclusion criteria [8][9][10][11][12][13][14][15][16][17][18][19], as detailed in the flow diagram ( Fig. 1).…”

“…SMAS results from the compression of the third part of the duodenum between the aorta and the superior mesenteric artery, that leads to marked narrowing of aortomesenteric angle and reduced aortomesenteric distance [1,5,8,9].…”

Laparoscopic management of a complicated case of Wilkie’s syndrome: A case report

“…It is thought to be due to the rapid and excessive weight loss that leads to the loss of the mesenteric fat around the artery [1], [2]. Other causes include high insertion of the ligament of Treitz and post spinal surgeries for the correction of spinal deformities [3].…”

“…The normal angle between the aorta and SMA has been described to range between 38° and 65°, whereas in Wilkie’s syndrome the angle is reduced to less than 20° leading to gastric outlet obstruction [2]. Loss of retroperitoneal fat due to rapid weight loss, surgeries for spinal deformities and high insertion of ligament of Treitz are among the commonest etiological factors for SMA syndrome [3]. Treatment options vary from conservative medical management for uncomplicated cases to surgical treatment, which can be either through open approach or laparoscopic surgery [4].…”

Tratamiento mínimamente invasivo del síndrome de Wilkie

“…Una vez se opta por esta última instancia, el cirujano tiene a su disposición múl-tiples herramientas, tanto en el abordaje abierto como en el mínimamente invasivo, tales como el procedimiento de Strong 19 , la gastroyeyunostomía 20 y la duodenoyeyunostomía 21 . En cuanto al manejo mínimamente invasivo, la evidencia actual se basa en reportes de caso; aunque con buena tasa de éxito, el reporte de la experiencia continúa siendo limitado 2,[22][23][24][25][26] . El procedimiento de Strong consiste en una cirugía desrotacional cuyo objetivo es reposicionar la tercera y cuarta porción del duodeno a la derecha de la arteria mesentérica superior.…”