Superior Mesenteric Artery Syndrome after Kyphosis Correction - A Case Report

Obstruction of the third part of duodenum by superior mesenteric artery is known as superior mesenteric artery syndrome. Incidence of superior mesenteric artery syndrome following spine deformity correction is 0.5-4.7%. Till now, this syndrome after isolated kyphosis correction with vertebral column resection is rarely reported in literature.

A 17-year-old male patient with normal body habitus presented with 80° of congenital thoracolumbar kyphosis. He underwent kyphosis correction with vertebral column resection and posterior instrumentation and posterior spinal fusion under neuro monitoring. Deformity correction was excellent; the patient was alright in immediate post-operative period. 2 weeks after surgery presented with repeated vomiting and abdominal pain. Contrast computed tomography was showing decreased aortomesenteric angle and decreased aortomesenteric distance which confirmed the diagnosis of superior mesenteric artery syndrome. Initial management was conservative, but as symptoms were progressive, duodenojejunostomy was done. The patient was completely recovered from obstructive symptoms.

Superior mesenteric artery syndrome is a life-threatening complication that can occur after spine deformity correction. Early recognition and appropriate measures are critical to prevent the development of severe complications including death.