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Updated: Jun 28, 2026

Multimodality Diagnosis of Mesenteric Ischemia
05:07

Multimodality Diagnosis of Mesenteric Ischemia

Published on: July 21, 2023

[A possible case of superior mesenteric artery syndrome of congenital origin]

J M Morán Penco1, J Cardenal Murillo, Pato U De La Calle

  • 1Clínica Quirúrgica San Francisco, Cáceres, Facultad de Medicina, Universidad de Extremadura, España. jmmoran@unex.es

Cirugia Pediatrica : Organo Oficial De La Sociedad Espanola De Cirugia Pediatrica
|November 13, 2008
PubMed

Insights

This case study details a 10-year-old boy with congenital superior mesenteric artery syndrome (SMAS), presenting with severe gastrointestinal issues. Surgical intervention, the Koecher maneuver, successfully resolved symptoms, offering long-term relief.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Vascular Anatomy

Background:

  • Superior Mesenteric Artery Syndrome (SMAS) is a rare condition causing duodenal obstruction.
  • Congenital SMAS, though uncommon, presents diagnostic challenges in pediatric patients.
  • Recurrent abdominal pain, distension, and vomiting are key symptoms requiring thorough investigation.

Observation:

  • A 10-year-old boy experienced persistent gastrointestinal distress since birth, worsening over two years.
  • Diagnostic imaging, including barium studies and CT scans, confirmed SMAS.
  • The patient had no significant weight loss, prior surgeries, or other concurrent illnesses.

Findings:

  • Surgical treatment via laparotomy and the Koecher maneuver successfully released the obstructed duodenum.
  • The procedure involved dividing the Treitz ligament to decompress the aorto-mesenteric space.
  • Post-operative follow-up over five years demonstrated an excellent clinical outcome.

Implications:

  • This case highlights the importance of considering congenital SMAS in pediatric patients with unexplained chronic gastrointestinal symptoms.
  • The Koecher maneuver is an effective surgical approach for treating SMAS.
  • Early diagnosis and surgical intervention can lead to significant long-term improvement in quality of life.

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