Laparoscopic Duodenojejunostomy for the Treatment of Superior Mesenteric Artery (SMA) Syndrome: Case Series

Superior mesenteric artery (SMA) syndrome is an atypical, rare cause of both acute and chronic high intestinal obstruction. Identification of this syndrome can be a diagnostic dilemma and is frequently made by exclusion. The most characteristic symptoms are postprandial epigastric pain, eructation, fullness, and voluminous vomiting. Symptoms are caused by compression of the third portion of the duodenum against the posterior structures by a narrow-angled SMA. When nonsurgical management is not possible or the problem is refractory, surgical intervention is necessary. In this article, we report a case series of SMA syndrome in 3 patients with radiologic evaluation confirming compression of the third portion of the duodenum by the SMA with resultant proximal dilatation. The patients all successfully underwent laparoscopic duodenojejunal anastomosis.