Advances in pediatric surgery

Korean Association of Pediatric Surgeons (대한소아외과학회)
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Laparoscopic Operation for Superior Mesenteric Artery Syndrome and Follow-up with 3-Dimensional Reconstructive CT - 1 Case Report -

상장간막동맥 증후군의 복강경 수술 및 3차원재건 복부 전산화단층촬영 영상을 이용한 추적관찰 -1예보고-

  • Kim, Seong-Min (Division of Pediatric Surgery, Department of Surgery, Yonsei University College of Medicine) ;
  • Kim, Sung-Hoon (Division of Pediatric Surgery, Department of Surgery, Yonsei University College of Medicine) ;
  • Kwon, In-Kyou (Division of Pediatric Surgery, Department of Surgery, Yonsei University College of Medicine) ;
  • Kim, Myoung-Joon (Department of Diagnostic Radiology, Yonsei University College of Medicine) ;
  • Hyoung, Woo-Jin (Department of Surgery, Yonsei University College of Medicine) ;
  • Choi, Seung-Hoon (Division of Pediatric Surgery, Department of Surgery, Yonsei University College of Medicine)
  • 김성민 (연세대학교 의과대학 소아외과) ;
  • 김성훈 (연세대학교 의과대학 소아외과) ;
  • 권인규 (연세대학교 의과대학 소아외과) ;
  • 김명준 (연세대학교 의과대학 진단방사선과) ;
  • 형우진 (연세대학교 의과대학 외과) ;
  • 최승훈 (연세대학교 의과대학 소아외과)
  • Published : 2005.12.31
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Abstract

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 3Dreconstructive CT scan, the angle between SMA and aorta was $37^{\circ}$. The postoperative course was uneventful. Three months later, he had gained 3 kg of weight and the angle between SMA and aorta increased to $38-39^{\circ}$ on 3D reconstructive CT scan. Laparoscopic duodenojejunostomy for bypassing the obstructive duodenum in SMA syndrome is a feasible and safe method.

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