Document Detail

Duodenal Obstruction From Mesenteric Stents Mimicking SMA Syndrome.
MedLine Citation:
PMID:  21872429     Owner:  NLM     Status:  Publisher    
BACKGROUND: Superior mesenteric artery (SMA) syndrome is a rare condition, which results in compression of the third portion of the duodenum by a narrow-angled SMA against the aorta. We report a case of a patient treated for chronic mesenteric ischemia, who developed an SMA-like syndrome as a result of the compression of the duodenum between an SMA stent and an inferior mesenteric artery (IMA) stent. METHODS AND RESULTS: A 44-year-old woman with chronic mesenteric ischemia had previously been treated with multiple endovascular stents. She re-presented with persistent abdominal pain and weight loss. Findings from the angiogram performed revealed an occluded celiac artery and an SMA. Mesenteric perfusion was maintained by the IMA with poor collateralization to the celiac circulation. At the time of surgical exploration, there were no suitable target sites for a traditional aortomesenteric bypass because of the extensive length of prior stenting. A renohepatic bypass with reversed saphenous vein was performed to improve the celiac circulation. Postoperatively, she continued to have persistent abdominal pain associated with nausea and vomiting. An upper gastrointestinal study was performed that revealed severe partial obstruction of the third portion of her duodenum. On re-reviewing her preoperative computed tomography scan of the abdomen, it was more apparent that the duodenum was constricted between the SMA and IMA stents that had been previously placed. She underwent re-exploration, and a side-to-side duodenojejunostomy was performed. Subsequent study of the upper gastrointestinal showed resolution of the obstruction. CONCLUSION: To our knowledge, this is the first report of duodenal obstruction caused as a result of the complications caused by multiple stent placements, which gave an impression of SMA-like syndrome.
Ying Wei Lum; Curt Bone; Jennie McKown; James H Black
Related Documents :
2353779 - The lateral genicular artery flap.
16649939 - Ultrasonographic and color-flow doppler ultrasonographic assessment of direct cutaneous...
20462899 - Determinants of a blunted carotid-to-radial pulse wave velocity decline in response to ...
9091919 - Closure of upper extremity soft-tissue defects using the new "supra-crest" fasciocutane...
9140949 - Use of distal arteries for microvascular reconstruction in forearm and hand surgery.
2679779 - Effect of cold pressor test on the internal diameter of the radial artery.
17921129 - Can leg pain be the sole presenting symptom of infective endocarditis? a case report.
16212459 - Great vessel transposition for antegrade delivery of the tag endoprosthesis in the prox...
8546289 - Resistance, reverse flow and opening pressure of unidirectional valves.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-25
Journal Detail:
Title:  Annals of vascular surgery     Volume:  -     ISSN:  1615-5947     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.
Division of Vascular Surgery and Endovascular Therapy, Johns Hopkins Hospital, Baltimore, Maryland.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Principles and Practice of Thromboelastography in Clinical Coagulation Management and Transfusion Pr...
Next Document:  The antigen specificity of the rheumatoid arthritis-associated ACPA directed to citrullinated fibrin...