Superior mesenteric artery syndrome as a complication of ileal pouch-anal anastomosis

Abstract

This case report suggests that a more conservative approach may be successful in managing this complication.

Superior Mesenteric Artery Syndrome: A Case Report of a Rare Postoperative Complication after Ileal Pouch-anal Anastomosis

“…The diagnosis is made by the association of vomiting, epigastric pain, and distention, with drainage of abundant gastric and bilious secretions [1,3,9]. Radiological contrast examination and or computed tomography scan are considered to be appropriate for the diagnosis [2,3]. CT demonstrate the location of the obstruction that occurs between the aorta and the superior mesenteric artery as observed in the present case (Figures 1 and 2), and it also contributes to wards the diagnosis of other postoperative intestinal obstruction.…”

“…In four cases reported, surgery was required [9]. The liberation of the duodenum from its retroperitoneal attachments, including the duodenojejunal flexure, as it was described by Strong [12] in 1958 could be more safely performed than division and reanastomosis of the duodenum [2].…”

“…The superior mesenteric artery syndrome is caused by compression of the third part of the duodenum in the angle between the aorta and the superior mesenteric artery [1,2], Frequently, predisposing medical conditions associated with catabolic states or rapid weight loss result in a decrease of the aortomesenteric angle and subsequent duodenal obstruction [1]. External compression, anatomic variants and surgical alteration of the anatomy following spine surgery or digestive surgery especially, ileoanal pouch anastomosis can also precipitate the syndrome [1,[3][4][5][6].…”

“…The conservative treatment consists on gastroduodenal decompression via a nasogastric tube, placing the patient in the prone or right lateral decubitus position [2,9], and parenteral nutrition. In this case, the conservative treatment allowed the gastroduodenal decompression.…”

Superior Mesenteric Artery Syndrome After Successful Coil Embolization of a Ruptured Pancreaticoduodenal Artery Aneurysm: Report of a Case

“…[1][2][3][4][5][6][7] Various disorders have been reported to cause a decrease in the vascular angle between the aorta and the SMA, resulting in obstruction of the duodenum. [1][2][3][4][5][6][7] We report a case of SMA syndrome, which occurred after successful coil embolization of a ruptured pancreaticoduodenal artery (PDA) aneurysm.…”