Superior mesenteric artery syndrome associated with scoliosis treated by a modified Ladd procedure.

A 16-year-old asthenic girl had idiopathic adolescent scoliosis and superior mesenteric artery (SMA) syndrome. After a Harrington rod procedure, the SMA syndrome produced a complete duodenal obstruction that did not resolve with nasogastric decompression, positioning, or peripheral intravenous nutrition. A complete derotation of the duodenum and the colon and stabilization of their mesentery (Ladd procedure with the Bill modification) resolved the obstruction and was considered the preferred operative treatment for this problem.