Laparoscopic duodenojejunostomy for management of superior mesenteric artery syndrome: Two cases report and a review of the literature

Ik Yong Kim, Nam Cheon Cho, Dae Sung Kim, Byoung Seon Rhoe

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Superior mesenteric artery(SMA) syndrome is rare disorder, which is caused by a reduction in the aortomesenteric angle causing a duodenal obstruction. It is usually occurs after a period of weight loss, nausea, and vomiting by a partial obstruction of the third portion of the duodenum. If conservative management fails then a laparotomy with a duodenojejunostomy is indicated. Recently, a minimally invasive or laparoscopic approach to the retroperitoneum or duodenal detachment was introduced. Although the role of a laparoscopy in managing SMA syndrome is not clearly defined, a laparoscopic duodenojejunostomy may be an alternative approach to the surgical treatment of SMA syndrome cases. Two cases of superior mesenteric artery syndrome that were treated laparoscopically after medical therapy failure are described. The 4-port procedure was performed. A dilated bowel on the third portion of the duodenum was observed below the transverse mesocolon and to right of the superior mesenteric artery. A proximal loop of the jejunum was anastomosed to the duodenum using an endoscopic GIA stapler. The surgery time and hospital length of stay were acceptable. No complications were encountered in this study. A laparoscopic duodenojejunostomy is a feasible alternative option for treating SMA syndrome. It provides the benefits of being a definitive and minimally invasive surgical technique in a duodenal obstruction.

Original languageEnglish
Pages (from-to)526-529
Number of pages4
JournalYonsei medical journal
Volume44
Issue number3
DOIs
Publication statusPublished - 2003 Jun 30

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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