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Title: Laparoscopic duodenojejunostomy for superior mesenteric artery syndrome
Authors: Singaporewalla, R.M.
Lomato, D. 
Ti, T.K. 
Keywords: Acute gastric dilatation
Laparoscopic duodenojejunostomy
Superior mesenteric artery syndrome
Issue Date: 2009
Citation: Singaporewalla, R.M., Lomato, D., Ti, T.K. (2009). Laparoscopic duodenojejunostomy for superior mesenteric artery syndrome. Journal of the Society of Laparoendoscopic Surgeons 13 (3) : 450-454. ScholarBank@NUS Repository.
Abstract: Background: Superior mesenteric artery syndrome (SMAS) is a rare condition causing acute or chronic compression of the third part of the duodenum, due to a reduction in the aortomesenteric angle. Traditionally, an open duodenojejunostomy is recommended when conservative management fails. Laparoscopic duodenojejunostomy is a minimally invasive option that has been reported in up to 10 cases. We describe our operative technique in one case and review the literature on this condition. Methods: A previously well 66-year-old man presented with acute gastric dilatation. An abdominal computerized tomography (CT) scan and oral Gastrografin meal revealed a dilated stomach and proximal duodenum due to compression of the third part of the duodenum between the superior mesenteric artery (SMA) and aorta. Results: Esophagogastroduodenoscopy (EGD) ruled out intraluminal causes. A laparoscopic duodenojejunostomy was performed when conservative management failed. Postoperative recovery was quick and uneventful. Gastrografin administration on the fifth day showed no leak with free flow of contrast into the jejunum. The patient resumed a normal diet and remained asymptomatic at 6-month follow-up. Conclusion: Laparoscopic duodenojejunostomy is feasible safe, and effective. It gives the same results as open surgery with all the advantages of minimally invasive surgery. © 2009 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. Published by the Society of Laparoendoscopic Surgeons, Inc.
Source Title: Journal of the Society of Laparoendoscopic Surgeons
ISSN: 10868089
Appears in Collections:Staff Publications

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