The Superior Mesenteric Artery Syndrome: A Rare Complication after Post-Traumatic Spine Surgery
Mounir Bouali
Department of Visceral Surgical Emergencies, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
El Batloussi Yousra *
Department of General Surgery, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
Abdelillah El Bakouri
Department of Visceral Surgical Emergencies, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
Fatimazahra Bensardi
Department of Visceral Surgical Emergencies, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
Khalid El Hattabi
Department of Visceral Surgical Emergencies, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
Abdelaziz Fadil
Department of Visceral Surgical Emergencies, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Superior mesenteric artery syndrome is a rare complication of post-traumatic spine surgery. The third portion of the duodenum is compressed between the abdominal aorta and the superior mesenteric artery: duodenal (intestinal) occlusion and sometimes arterio-mesenteric occlusion occur. We report the case of a young male patient, in whom this syndrome occurred after spinal surgery. He had fractures in the dorso-lumbar vertebrae. The patient had undergone an osteosynthesis. On a post-operative day 3, he had vomiting. Abdominal CT revealed the findings indicative of superior mesenteric artery syndrome: gastric dilatation and complete halt of the third part of the duodenum. We chose conservative treatment: the rest of the digestive tract, early parenteral nutrition, and correction of fluid and electrolyte imbalances. These treatments did not ameliorate the condition and thus we performed laparotomic gastro-jejunal bypass, which completely ameliorated the condition. The patient was discharged on the 7 postoperative day. We here summarize the clinical features and treatment fundamentals of this disorder.
Keywords: Superior mesenteric artery, duodenal obstruction, post traumatic spin surgery