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腹腔镜治疗肠系膜上动脉综合征:病例报告。

Superior mesenteric artery syndrome managed laparoscopically: a case report.

机构信息

Department of General Surgery, PCMC's PGI YCM Hospital, Pune, Maharashtra, India.

出版信息

J Med Case Rep. 2024 Aug 23;18(1):391. doi: 10.1186/s13256-024-04703-z.

Abstract

BACKGROUND

Superior mesenteric artery syndrome is a rare condition that has only around 400 reported cases so far. Typically, the superior mesenteric artery branches off the abdominal aorta at 45° to create an aortomesenteric distance of 10-28 mm, with the duodenum passing through. However, if this aortomesenteric angle reduces to less than 25°, the third portion of the duodenum becomes compressed between the SMA and aorta, causing mechanical obstruction.

CASE PRESENTATION

This case report aims to demonstrate the diagnostic difficulties and the laparoscopic management of a 52-year-old Indian male presenting with abdominal pain and vomiting, with associated weight loss. Imaging was further suggestive of high intestinal obstruction, and he was later found to have superior mesenteric artery syndrome.

CONCLUSION

Taking into account a significant reduction in morbidity, we propose laparoscopic duodenojejunostomy to be the new procedure of choice for superior mesenteric artery syndrome.

摘要

背景

肠系膜上动脉综合征是一种罕见的疾病,迄今为止,全球仅有约 400 例报告病例。通常情况下,肠系膜上动脉在腹主动脉呈 45°角分支,形成肠系膜上动脉与腹主动脉之间的距离为 10-28mm,十二指肠穿行其中。然而,如果这个夹角减小到小于 25°,第三段十二指肠会被 SMA 和主动脉之间的压迫,导致机械性梗阻。

病例介绍

本病例报告旨在展示一例 52 岁印度男性的诊断困难和腹腔镜处理方法,他表现为腹痛、呕吐,伴有体重减轻。影像学进一步提示高位肠梗阻,后来发现他患有肠系膜上动脉综合征。

结论

考虑到发病率显著降低,我们建议腹腔镜十二指肠空肠吻合术成为肠系膜上动脉综合征的新选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cf3/11342525/6a5bf2de3983/13256_2024_4703_Fig1_HTML.jpg

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