Document Detail

Superior mesenteric artery syndrome: a rare cause of complete intestinal obstruction in neonates.
MedLine Citation:
PMID:  22152903     Owner:  NLM     Status:  In-Data-Review    
Superior mesenteric artery syndrome (SMAS) is an uncommon cause of high intestinal obstruction in neonates; it is owing to incomplete obstruction in the third part of the duodenum caused by compression between the SMA and abdominal aorta. In neonates, complete intestinal obstruction owing to SMAS has been very rarely reported in the literature .We present a 7-day-old previously healthy male infant with a short history of gastroenteritis and sepsis followed by progressive abdominal distension and persistent bilious vomiting that resulted in hypovolemic shock. The patient was aggressively resuscitated, and a gastrografin study showed a hugely distended stomach with an abrupt narrowing at the third part of the duodenum. Exploratory laparotomy unexpectedly revealed a high insertion of the duodenum at the ligament of Treitz, with upward displacement and SMA compression leading to duodenal obstruction. The ligament of Treitz was divided, and the duodenum, mobilized. The postoperative course was uneventful. Although extremely rare, SMAS should be considered as one of the differential diagnoses in newborns presenting with complete intestinal obstruction, especially if preceded by gastroenteritis or sepsis-like symptoms.
Rafat Mosalli; Bassam El-Bizre; Mansoor Farooqui; Bosco Paes
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  46     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e29-31     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Department of Pediatrics, Umm Al Qura University, Mecca, Saudi Arabia; Department of Pediatrics, International Medical Center, Jeddah, Saudi Arabia.
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