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Laparoscopic Ladd's procedure for superior mesenteric artery syndrome
Mohammad Alsulaimy1, Jun Tashiro1, Eduardo A Perez1
1Division of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA.
Journal of Pediatric Surgery
|October 5, 2014
Summary
Superior mesenteric artery (SMA) syndrome, a rare duodenal obstruction, was effectively treated with a laparoscopic Ladd's procedure in a teenage patient. This surgical approach resolved the compression and relieved symptoms, allowing for a full recovery.
Area of Science:
- Gastroenterology
- Surgical Procedures
- Anatomy
Background:
- Superior mesenteric artery (SMA) syndrome is a rare condition characterized by duodenal compression between the SMA and aorta.
- It often presents with symptoms like postprandial abdominal pain and weight loss.
Observation:
- A 17-year-old female presented with a two-month history of symptoms consistent with SMA syndrome.
- Initial conservative management with nasojejunal tube feeding for four months resulted in weight gain but did not resolve symptoms.
- Repeat upper gastrointestinal (UGI) series confirmed persistent SMA syndrome.
Findings:
- A laparoscopic Ladd's procedure was performed as the definitive treatment.
- The surgical steps included mobilization of the Ligament of Treitz, right colon mobilization, duodenal derotation, and small bowel repositioning.
- Postoperative UGI confirmed complete resolution of the SMA compression of the duodenum.
Implications:
- Laparoscopic Ladd's procedure is an effective treatment for SMA syndrome.
- Surgical intervention can lead to immediate symptom resolution and full recovery.
- This case highlights the successful application of minimally invasive surgery for this uncommon condition.
