RESUMO
INTRODUCTION AND IMPORTANCE: Due to a decrease in the aortomesenteric angle, the third section of the duodenum can become acutely or chronically compressed in the superior mesenteric artery syndrome (SMAS). CASE PRESENTATION: A 31-year-old male patient complained of one-year-long recurrent postprandial abdominal pain, periumbilical, intermittent, and colicky. The pain increased in severity in the last 4 months and was relieved only with self-induced vomiting and partially with the knee-to-chest position. A CT scan was done and is most consistent with superior mesenteric artery syndrome. The patient was admitted to the operating room and underwent a successful laparoscopic duodenectomy of the third part of duodenum followed by duodenojejunostomy. CLINICAL DISCUSSION: When conservative therapy fails, an open duodenojejunostomy is traditionally advised. A less invasive option that has been documented in up to 10 cases is laparoscopic duodenojejunostomy. We discuss the research on this issue and demonstrate our surgical method on one patient. CONCLUSION: Even if there has been just a modest amount of weight loss, SMAS should be taken into account whenever a sudden observation of gastrointestinal obstruction symptoms is noted in patients with susceptible conditions such as low body weight.
