SMA Syndrome after Corrective Surgery of Thoracic Kyphoscoliosis -A Case Report-

Jeong Hyun Ha; Young Joon Ahn; Jae Hyup Lee; Won Chul Choi; Bong-Soon Chang; Choon-Ki Lee

doi:10.7469/JKSS.2003.10.2.202

Journal List > J Korean Soc Spine Surg > v.10(2) > 1035578

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Ha, Ahn, Lee, Choi, Chang, and Lee: SMA Syndrome after Corrective Surgery of Thoracic Kyphoscoliosis -A Case Report-

Case Report

Journal of Korean Spine Surg 2003;10(2):202-207.

Published online: 18 December 2003

DOI: https://doi.org/10.7469/JKSS.2003.10.2.202

SMA Syndrome after Corrective Surgery of Thoracic Kyphoscoliosis -A Case Report-

Jeong Hyun Ha, Young Joon Ahn^∗, Jae Hyup Lee, Won Chul Choi, Bong-Soon Chang, Choon-Ki Lee

Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea

^∗Asan Medical Center, Ulsan University, College of Medicine, Seoul, Korea

Address reprint requests to Choon-Ki Lee, M.D. Department of Orthopaedic Surgery, Seoul National University College of Medicine, #28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea Tel: 82-2-760-2336, Fax: 82-2-764-2718, E-mail: choonki@plaza.snu.ac.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Superior mesenteric artery (SMA) syndrome is a rare condition that results from an extrinsic compression of the third portion of the duodenum, between the SMA and the aorta. The symptoms for the condition consist of abdominal pain and recurrent vomiting, caused by ileus, and can be followed by an electrolyte imbalance and nutrient deficiency. SMA syndrome can follow surgical correction of a spinal deformity, as the aorta migrates forward as the degree of the lumbar lordosis increases, and the retroperitoneal fat tissue decreases, during perioperative abstinence. A ny symptoms suggestive of SMA syndrome, after correction of a spinal deformity, should be investigated, as SMA syndrome carries a prolonged hospital stay, with the potential for mortality. A n 11year 10 month old boy, who underwent correction for thoracic kyphoscoliosis, developed postoperative abdominal distension, pain and bilious vomiting. A n upper gastrointestinal contrast study revealed SMA syndrome, which required a laparotomy.

Keywords: SMA syndrome, Kyphoscoliosis

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Fig. 1.

Diagrammatic representation of superior mesenteric artery syndrome

Fig. 2.

11+10-year-old male. Thoracic kyphoscoliosis. Preoperative standing anteroposterior (A) and lateral (B) radiographs.

Fig. 3.

Postoperative anteroposterior (A) and lateral (B) radiographs following anteroposterior fusion from T5 to L3.

Fig. 4.

Upper gastrointestinal contrast study at postoperative 7th days. It shows a cutoff at the junction of the second and the third part of the duodenum representing extrinsic compression by the superior mesenteric artery.

Fig. 5.

Upper gastrointestinal contrast study at postoperative 23th days, following 11days of total parenteral nutrition treatment. It shows no remarkable change since last study.

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