The Superior Mesenteric Artery Syndrome: A Rare Complication after Post-Traumatic Spine Surgery

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.