Wong Liam H, Sutton Thomas L, Spurrier Ryan G, Zigman Andrew F, Mayo Skye C
School of Medicine, Oregon Health & Science University (OHSU), 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA.
Division of Surgical Oncology, Oregon Health & Science University (OHSU), 3181, SW Sam Jackson Park Rd, Portland, OR 97239, USA.
Clin Pract. 2020 Dec 24;11(1):2-7. doi: 10.3390/clinpract11010002.
Superior mesenteric artery (SMA) syndrome is an uncommon phenomenon caused by the compression of the third portion of the duodenum between the aorta and the SMA. Here, we present a previously healthy 15-year-old male who presented with early satiety and 20 kg weight loss. Computed tomography (CT) demonstrated a massive retroperitoneal liposarcoma displacing the entire small intestine into the right upper quadrant. Following resection of the large mass, the patient was intolerant of oral intake despite evidence of bowel function. Abdominal CT revealed a narrowing of the duodenum at the location of the SMA. A nasojejunal feeding tube was placed past this area, and enteral nutrition was initiated before slowly resuming oral intake. Post-operative SMA syndrome is an uncommon complication but should be considered in patients intolerant of oral intake following resection of large abdominal tumors associated with extensive retroperitoneal fat loss, even in the absence of concomitant major visceral resection.
肠系膜上动脉（SMA）综合征是一种罕见的现象，由十二指肠第三部在主动脉和肠系膜上动脉之间受压引起。在此，我们报告一名既往健康的15岁男性，他出现早饱并体重减轻20千克。计算机断层扫描（CT）显示一个巨大的腹膜后脂肪肉瘤，将整个小肠推移至右上腹。在切除巨大肿块后，尽管肠道功能正常，但患者仍无法耐受经口进食。腹部CT显示在肠系膜上动脉处十二指肠变窄。一根鼻空肠饲管越过该区域放置，在缓慢恢复经口进食之前开始肠内营养。术后SMA综合征是一种罕见的并发症，但对于切除与广泛腹膜后脂肪丢失相关的大型腹部肿瘤后无法耐受经口进食的患者，即使没有同时进行主要内脏切除，也应考虑到这一情况。
