Laparoscopic Operation for Superior Mesenteric Artery Syndrome and Follow-up with 3-Dimensional Reconstructive CT: 1 Case Report

Superior mesenteric artery (SMA) syndrome is a rare disorder caused by extrinsic compression of the third portion of the duodenum by the SMA. The operative treatment of choice is bypassing the obstructed duodenal segment by duodenojejunostomy. We report one case of SMA syndrome treated by laparoscopic duodenojejunostomy and followed up by 3D-reconstructive CT scan. A fifteen-year-old boy with intermittent vomiting and weight loss was admitted. Ultrasonography showed narrowing of the distance between the SMA and aorta. Hypotonic duodenography showed dilatation of duodenal third portion and barium stasis. On 3D-reconstructive CT scan, the angle between SMA and aorta was 37 degrees. The postoperative course was uneventful. Three months later, he had gained 3 kg of weight and the angle between SMA and aorta increased to 38-39 degrees on 3D reconstructive CT scan. Laparoscopic duodenojejunostomy for bypassing the obstructive duodenum in SMA syndrome is a feasible and safe method.

Ovarian Pregnancy: Two Cases Report / 대한산부인과학회지

Ovarian pregnancy is an uncommon variant of ectopic pregnancy. Spiegelberg's criteria should be fulfilled for the diagnosis of ovarian pregnancy. The reported incidence is 0.5-3% of all ectopic pregnancies. The reported frequency of ovarian pregnancies remained stable. It seems that the frequency is underestimated because some of the suspected tubal pregnancies treated conservatively with methotrexate, without laparoscopic validation, are in fact early ovarian pregnancy. The improvements in ultrasonography, methods for hCG detection, and operative laparoscopy have led to earlier and more accurate diagnosis of ovarian pregnancies. The therapy of ovarian pregnancy is surgical in the first place, and medical treatment with systemic or local methotrexate injection can be applicable after confirming diagnosis of ovarian pregnancy by laparoscopy, in women in a stable condition. Two cases of histologically proven primary ovarian pregnancy are presented with brief review of literature.