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Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
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Post-Operative Superior Mesenteric Artery Syndrome Following Retroperitoneal Sarcoma Resection
Liam H Wong1, Thomas L Sutton2, Ryan G Spurrier3,4
1School of Medicine, Oregon Health & Science University (OHSU), 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA.
Clinics and Practice
|February 18, 2021
Summary
Superior mesenteric artery (SMA) syndrome, a rare condition, can occur after abdominal surgery. This case highlights its development in a patient post-liposarcoma resection, emphasizing the need for consideration in post-operative feeding intolerance.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Radiology
Background:
- Superior mesenteric artery (SMA) syndrome is characterized by duodenal compression between the aorta and SMA.
- It is an uncommon complication, particularly in the post-operative setting.
Observation:
- A 15-year-old male presented with early satiety and significant weight loss.
- Imaging revealed a massive retroperitoneal liposarcoma causing small bowel displacement.
- Post-resection, the patient experienced intolerance to oral intake.
Findings:
- Abdominal CT identified duodenal narrowing at the SMA, consistent with SMA syndrome.
- A nasojejunal tube facilitated enteral nutrition, enabling gradual resumption of oral intake.
- This suggests post-operative SMA syndrome can occur even without direct visceral resection.
Implications:
- Post-operative SMA syndrome should be considered in patients with feeding intolerance after large abdominal tumor resection, especially with significant retroperitoneal fat loss.
- Early diagnosis and management with enteral feeding are crucial for recovery.
- This case expands the understanding of SMA syndrome etiology and presentation.
