EJMCR. 2020; 4(7): 240-244

Superior mesenteric artery syndrome: a case report and a novel surgical approach

Authors: Ana Paula Fernandes Braga, Silvio Pereira Borges Junior, Daniella Montecino Vaz de Melo, Thais de Moura Braga, Helbert de Paula Pupo Nogueira, Julia Salles Rezende Dias, Thomas Diniz Moura, Vinicius Rodrigues Taranto Nunes.

ABSTRACT

Background: Superior mesenteric artery syndrome (SMAS) is a rare cause of duodenal obstruction that has non-specific and insidious symptoms. An initial treatment is conservative, and surgery is reserved for patients who continuously present with symptoms or complications. The aim of this study is to describe a combination of two surgical techniques: duodenojejunostomy and Strong’s procedure (the release of the Treitz ligament) through a laparoscopic approach. This combination of both techniques has already been described, however, with a lack of technical detail. Case Presentation: This report presents the case of a 19-year-old male diagnosed with SMAS, confirmed through computed tomography and angiographic magnetic resonance imaging of the abdomen. He underwent a laparoscopic duodenojejunostomy and release of the Treitz’s ligament. The patient recovered well with no complications and was discharged 5 days postoperatively. Conclusion: Due to the rarity of the disease, there is a lack of literature comparing the benefits of either of these two techniques, and also, there are no established protocols favoring the use of one procedure over the other. In this case, we combined both techniques to reduce the rate of recurrence, increase the anastomotic safety, and reduce long-term complications. However, a larger study would be necessary to establish the combined use of these two techniques.

Keywords:
Superior mesenteric artery syndrome, Wilkie’s syndrome, duodenal obstruction, laparoscopy, duodenojejunostomy, Strong’s procedure


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Superior mesenteric artery syndrome: a case report and a novel surgical approach


Authors
Ana Paula Fernandes Braga
Post Graduate Trainee of Surgery, Hospital da Policia Militar de Minas Gerais, Belo Horizonte, Brazil
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Silvio Pereira Borges Junior
Post Graduate Trainee of Surgery, Hospital da Policia Militar de Minas Gerais, Belo Horizonte, Brazil
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Daniella Montecino Vaz de Melo
Post Graduate Trainee of Surgery, Hospital da Policia Militar de Minas Gerais, Belo Horizonte, Brazil
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Thais de Moura Braga
Post Graduate Trainee of Surgery, Hospital da Policia Militar de Minas Gerais, Belo Horizonte, Brazil
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Helbert de Paula Pupo Nogueira
Post Graduate Trainee of Surgery, Hospital da Policia Militar de Minas Gerais, Belo Horizonte, Brazil
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Julia Salles Rezende Dias
Post Graduate Trainee of Surgery, Hospital da Policia Militar de Minas Gerais, Belo Horizonte, Brazil
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Thomas Diniz Moura
6th year Medical student in Federal University of Minas Gerais, Medical School, Belo Horizonte, Brazil
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Vinicius Rodrigues Taranto Nunes
General Surgeon, Hospital da Policia Militar de Minas Gerais, Belo Horizonte, Brazil
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Correspondence to:
. Vinícius Rodrigues Taranto Nunes, Medical Doctor at Hospital da Policia Militar de Minas Gerais, Belo Horizonte, Brazil; vivas1912@hotmail.com

Publication history
Received 09 May 2020
Revised 17 Jun 2020
Accepted 24 Jun 2020
Published online 09 Jul 2020
Published in print 06 Aug 2020

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Pubmed Style

Braga APF, Junior SPB, Melo DMVd, Braga TdM, Nogueira HdPP, Dias JSR, Moura TD, Nunes VRT. Superior mesenteric artery syndrome: a case report and a novel surgical approach. EJMCR. 2020; 4(7): 240-244. doi:10.24911/ejmcr/173-1589020023


Web Style

Braga APF, Junior SPB, Melo DMVd, Braga TdM, Nogueira HdPP, Dias JSR, Moura TD, Nunes VRT. Superior mesenteric artery syndrome: a case report and a novel surgical approach. https://www.ejmcr.com/?mno=105814 [Access: September 24, 2020]. doi:10.24911/ejmcr/173-1589020023


AMA (American Medical Association) Style

Braga APF, Junior SPB, Melo DMVd, Braga TdM, Nogueira HdPP, Dias JSR, Moura TD, Nunes VRT. Superior mesenteric artery syndrome: a case report and a novel surgical approach. EJMCR. 2020; 4(7): 240-244. doi:10.24911/ejmcr/173-1589020023


Vancouver/ICMJE Style

Braga APF, Junior SPB, Melo DMVd, Braga TdM, Nogueira HdPP, Dias JSR, Moura TD, Nunes VRT. Superior mesenteric artery syndrome: a case report and a novel surgical approach. EJMCR. (2020), [cited September 24, 2020]; 4(7): 240-244. doi:10.24911/ejmcr/173-1589020023


Harvard Style

Braga, A. P. F., Junior, . S. P. B., Melo, . D. M. V. d., Braga, . T. d. M., Nogueira, . H. d. P. P., Dias, . J. S. R., Moura, . T. D. & Nunes, . V. R. T. (2020) Superior mesenteric artery syndrome: a case report and a novel surgical approach. EJMCR, 4 (7), 240-244. doi:10.24911/ejmcr/173-1589020023


Turabian Style

Braga, Ana Paula Fernandes, Silvio Pereira Borges Junior, Daniella Montecino Vaz de Melo, Thais de Moura Braga, Helbert de Paula Pupo Nogueira, Julia Salles Rezende Dias, Thomas Diniz Moura, and Vinicius Rodrigues Taranto Nunes. 2020. Superior mesenteric artery syndrome: a case report and a novel surgical approach. European Journal of Medical Case Reports, 4 (7), 240-244. doi:10.24911/ejmcr/173-1589020023


Chicago Style

Braga, Ana Paula Fernandes, Silvio Pereira Borges Junior, Daniella Montecino Vaz de Melo, Thais de Moura Braga, Helbert de Paula Pupo Nogueira, Julia Salles Rezende Dias, Thomas Diniz Moura, and Vinicius Rodrigues Taranto Nunes. "Superior mesenteric artery syndrome: a case report and a novel surgical approach." European Journal of Medical Case Reports 4 (2020), 240-244. doi:10.24911/ejmcr/173-1589020023


MLA (The Modern Language Association) Style

Braga, Ana Paula Fernandes, Silvio Pereira Borges Junior, Daniella Montecino Vaz de Melo, Thais de Moura Braga, Helbert de Paula Pupo Nogueira, Julia Salles Rezende Dias, Thomas Diniz Moura, and Vinicius Rodrigues Taranto Nunes. "Superior mesenteric artery syndrome: a case report and a novel surgical approach." European Journal of Medical Case Reports 4.7 (2020), 240-244. Print. doi:10.24911/ejmcr/173-1589020023


APA (American Psychological Association) Style

Braga, A. P. F., Junior, . S. P. B., Melo, . D. M. V. d., Braga, . T. d. M., Nogueira, . H. d. P. P., Dias, . J. S. R., Moura, . T. D. & Nunes, . V. R. T. (2020) Superior mesenteric artery syndrome: a case report and a novel surgical approach. European Journal of Medical Case Reports, 4 (7), 240-244. doi:10.24911/ejmcr/173-1589020023


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