Superior mesenteric artery syndrome after scoliosis correction surgery - A case report

Abstract

Introduction: Superior Mesenteric Artery Syndrome is a rare and life-threatening complication; it's also known as a Cast Syndrome. It can occur as a result of mechanical compression of the duodenum third part between the superior mesenteric artery and the aorta. The Aorto-mesenteric angle usually gets reduced in procedures resulting in vertebral lengthening like scoliosis correction, especially in patients with low body mass index (BMI). Presentation of the case: The reported case is for a 15 years old underweight male who was diagnosed as a case of progressive idiopathic thoracolumbar scoliosis. He underwent spine correction with posterior instrumented fusion. Five days following the surgery he started having abdominal pain with bilious vomiting and electrolytes imbalance that resulted in a rapid weight loss. Clinical and radiological findings were suggestive of Superior mesenteric artery syndrome. The patient was managed conservatively with high caloric parenteral nutritional support and gradual oral intake, which improved his condition. Conclusion: Superior mesenteric artery syndrome is a rare potentially fatal condition and difficult to diagnose, hence it needs high index of suspicion especially in under-weighted patients undergoing surgical correction of adolescent scoliosis. Identification of pre and post-operative risk factors can prevent morbidities and mortalities associated with this condition.

Keywords

• Superior mesenteric artery
• Aortomesenteric angle
• Scoliosis
• Case report
• Duodenal obstruction