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A Journal on Surgery

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Chirurgia 2000 February;13(1):35-8

language: English

Recurrent superior mesenteric artery syndrome (SMAS). Case report and reviews of the literature

Zanon C., Bortolini M., Clara R., Rizzo M., Goss M.


Superior mesenteric artery syndrome (SMA) is a rare entity and only 400 cases are described in the literature. In personal experience, a 30 year-old woman who had a recurrent SMAS has been treated. In 1995 a duodenojejunostomy was carried out. Nine months later symptomatology relapsed. Diagnosis was performed radiologically. Examination with barium meal and endoscopy confirmed an enlargement of duodenum and a 3rd duodenal obstruction. Medical therapy was not helpful and the patient was submitted to a second operation. Intraoperatively the previous duodenojejunostomy a as found to be displaced to the left of the superior mesenteric artery, so it was taken down and a Roux-an-Y duodenojejunostomy was performed. At follow-up, 12 months later the patient is still well. This syndrome is a rare condition and in the literature only one case of recurrence of SMAS is reported. This is the second report described and also in this case a Roux-en-Y duodenojejunostomy was able to correct previous failure operation. According to personal experience, the conclusion is drawn that this procedure is mandatory in the surgical treatment to avoid a relapse of SMAS.

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