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肠系膜上动脉综合征——脊柱畸形手术矫正后的一种罕见并发症。

Superior Mesenteric Artery Syndrome - An Uncommon Complication After Surgical Corrections of Spinal Deformities.

作者信息

Araujo Alex Oliveira de, Oliveira Rafael Garcia de, Arraes Amanda Jordão de Castro, Mamare Eduardo Magalhães, Rocha Ivan Dias, Gomes Cicero Ricardo

机构信息

Departamento de Ortopedia, Rede Sarah de Hospitais de Reabilitação, Brasília, DF, Brasil.

Departamento de Cirurgia Geral, Rede Sarah de Hospitais de Reabilitação, Brasília, DF, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2021 Aug;56(4):523-527. doi: 10.1055/s-0040-1722258. Epub 2021 Aug 30.

Abstract

Vascular compression of the third part of the duodenum by the superior mesenteric artery results in an unusual occlusion of the duodenal transit known as superior mesenteric artery syndrome. This syndrome can occur after surgeries to correct spinal deformities in a rate ranging from 0.5% to 4.7%. It results from a positional alteration of the artery emergency point due to a change in trunk length after surgery. It is associated with risk factors such as low body mass index and weight loss. Patients usually present with intestinal occlusion, abdominal pain, nausea, bilious vomiting, and early satiety. Superior mesenteric artery syndrome must be recognized early to institute an adequate treatment, which can be clinical (with gastric tube for decompression and nutritional support) or require a surgical procedure. Secondary complications related to superior mesenteric artery syndrome include delayed surgical and nutritional recovery, healing problems, and prolonged hospitalization. The present study aims to report a case of superior mesenteric artery syndrome in a patient with neuromuscular scoliosis secondary to a transverse myelitis who underwent surgical treatment for spinal deformity correction.

摘要

肠系膜上动脉对十二指肠第三部的血管压迫导致十二指肠通过异常受阻,称为肠系膜上动脉综合征。该综合征在脊柱畸形矫正手术后的发生率为0.5%至4.7%。它是由于手术后躯干长度改变导致动脉起始点位置改变所致。它与低体重指数和体重减轻等危险因素有关。患者通常表现为肠梗阻、腹痛、恶心、胆汁性呕吐和早饱感。必须早期识别肠系膜上动脉综合征以便进行适当治疗,治疗方法可以是临床治疗(使用胃管进行减压和营养支持)或需要进行外科手术。与肠系膜上动脉综合征相关的继发性并发症包括手术和营养恢复延迟、愈合问题以及住院时间延长。本研究旨在报告一例继发于横贯性脊髓炎的神经肌肉型脊柱侧凸患者发生肠系膜上动脉综合征的病例,该患者接受了脊柱畸形矫正手术治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fe0/8405258/318f77ff0991/10-1055-s-0040-1722258-i2000189en-1.jpg

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