Xu Ming-Ming, Dawod Enad, Gaidhane Monica, Tyberg Amy, Kahaleh Michel
Division of Gastroenterology, Kaiser Permanente, Los Angeles, CA, USA.
Division of Gastroenterology, Weill Cornell Medical College, New York, NY, USA.
Clin Endosc. 2020 Jan;53(1):94-96. doi: 10.5946/ce.2018.196. Epub 2019 Dec 3.
Superior mesenteric artery syndrome (SMAS) causes compression and partial or complete obstruction of the duodenum, resulting in abdominal pain, nausea, vomiting, and weight loss. If conservative therapy fails, the patient is typically referred for enteral feeding or laparoscopic gastrojejunostomy. The last few years have seen increasing use of endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) for gastric obstruction indications. EUS-GJ involves the creation of a gastric bypass via an echoendoscope in cases in which the small intestine can be punctured under ultrasonographic visualization, resulting in an incision-free, efficient, and safe procedure. In this case report, we present the first case of SMAS treated using a reverse EUS-GJ, and describe the steps and advantages of the procedure in this particular case.
肠系膜上动脉综合征（SMAS）可导致十二指肠受压以及部分或完全梗阻，从而引起腹痛、恶心、呕吐和体重减轻。若保守治疗失败，患者通常会接受肠内喂养或腹腔镜胃空肠吻合术。在过去几年中，内镜超声引导下胃空肠吻合术（EUS-GJ）在胃梗阻适应症中的应用越来越多。EUS-GJ是在超声可视化下可穿刺小肠的情况下，通过超声内镜创建胃旁路，从而实现无切口、高效且安全的手术。在本病例报告中，我们展示了首例采用逆向EUS-GJ治疗SMAS的病例，并描述了该特定病例中手术的步骤及优势。
