Anterior transposition of the third part of the duodenum in the management of chronic duodenal compression by the superior mesenteric artery.

Transposition of the third part of the duodenum anteriorly to the superior mesenteric vessels was performed in ten patients with chronic duodenal obstruction due to compression by the superior mesenteric artery (SMAS). Follow-up evaluation showed that all the patients (a) had complete relief of their preoperative symptoms, (b) could tolerate normal diet postoperatively and (c) gained weight rapidly following surgery. There were no major complications or deaths among the patients so treated. The Author feels that this technique is more direct approach, aimed at permanently circumventing the obstruction for these groups of patients selected on the basis of the radiological, pathological and operative findings. The success encountered with the patients so treated would seem to confirm this impression.