Ehlers Till-Oliver, Tsamalaidze Levan, Pereira Lucio, Stauffer John
Klinik für Allgemein-, Viszeral- und Onkologische Chirurgie, Evangelisches Krankenhaus Düsseldorf, Germany.
Department of General Surgery, Mayo Clinic, Jacksonville, United States.
Zentralbl Chir. 2018 Oct;143(5):461-463. doi: 10.1055/a-0668-1991. Epub 2018 Oct 24.
The Superior Mesenteric Artery Syndrome (SMAS) was first described by Rokitansky in 1842. Clinical symptoms include postprandial pain, nausea, vomiting and weight loss. Duodenojejunostomy is the treatment of choice for patients with SMAS. We now present a case of a young female with SMAS who successfully underwent laparoscopic duodenojejunostomy.
The first line treatment for SMAS is medical management, which includes infusion therapy, bowel rest, parenteral nutrition and a nasojejunal feeding tube inserted into the jejunum past the obstruction. If medical therapy fails, surgery is recommended.
A symptomatic patient with body mass index (BMI) of 19.4 kg/m underwent laparoscopic duodenojejunostomy. The patient tolerated the procedure well. The post-operative period was uneventful and the patient was discharged after three days. On six month follow up, the patient had gained weight and her symptoms were completely resolved.
SMAS is still a poorly recognised pathology. A high index of suspicion should be given for patients with unclear causes of postprandial nausea, vomiting and abdominal pain, especially in young females. A laparoscopic approach seems to be safe and effective for patients with SMAS.
肠系膜上动脉综合征（SMAS）于1842年由罗基坦斯基首次描述。临床症状包括餐后疼痛、恶心、呕吐和体重减轻。十二指肠空肠吻合术是SMAS患者的首选治疗方法。我们现报告一例成功接受腹腔镜十二指肠空肠吻合术的年轻女性SMAS病例。
SMAS的一线治疗是药物治疗，包括输液治疗、肠道休息、肠外营养以及在梗阻部位以下的空肠插入鼻空肠喂养管。如果药物治疗失败，则建议进行手术。
一名体重指数（BMI）为19.4kg/m²的有症状患者接受了腹腔镜十二指肠空肠吻合术。患者对手术耐受良好。术后恢复顺利，患者在三天后出院。在六个月的随访中，患者体重增加，症状完全缓解。
SMAS仍然是一种认识不足的疾病。对于餐后恶心、呕吐和腹痛原因不明的患者，尤其是年轻女性，应高度怀疑该病。腹腔镜手术方法对SMAS患者似乎是安全有效的。
