LAPAROSCOPIC DUODENOJEJUNOSTOMY IN A CASE OF SUPERIOR MESENTERIC ARTERY SYNDROME OR WILKIE’S SYNDROME, WITH VIDEO saraclaudia.b@gmail.com

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LAPAROSCOPIC DUODENOJEJUNOSTOMY IN A CASE OF SUPERIOR MESENTERIC ARTERY SYNDROME OR WILKIE’S SYNDROME, WITH VIDEO

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Italy

Video

Superior mesenteric artery syndrome (SMAS), also known as Wilkie’s syndrome, is a rare but potentially debilitating condition resulting from extrinsic compression of the third portion of the duodenum between the superior mesenteric artery (SMA) and the abdominal aorta (AA). This compression can cause a partial or complete duodenal obstruction, leading to symptoms like early satiety, postprandial abdominal pain, nausea, vomiting, and progressive weight loss. Diagnosis is confirmed by imaging, including CT scan, which reveals a narrowed aorto-mesenteric angle and decreased distance between the SMA and the AA.

We report the case of a 30-year-old female presenting with a six-month history of progressive postprandial abdominal pain and a 30 kg weight loss. Radiologic evaluation with oral contrast X-ray and CT imaging showed narrowing of the third portion of the duodenum, with an aorto-mesenteric angle (AMA) of 15°. Considering the patient’s poor response to conservative nutritional therapy, a laparoscopic latero-lateral duodenojejunostomy was performed.

The patient remained asymptomatic at one-year follow-up, regained weight, and at the endoscopic evaluation were no evidence of obstruction.

This case supports the growing evidence that laparoscopic duodenojejunostomy is a safe and effective surgical option for SMAS in patients unresponsive to conservative therapy.

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