Wilkie's Syndrome: Laparoscopic Duodenojejunostomy

Area of Science:

• Gastroenterology
• Surgical Case Reports

Background:

• Superior mesenteric artery syndrome (SMAS) is a rare condition characterized by duodenal compression between the aorta and superior mesenteric artery, often due to a narrow aortomesenteric angle (<25°).
• Clinical presentation includes chronic abdominal pain, vomiting, early satiety, and weight loss, predominantly affecting young women.
• Diagnosis is typically confirmed via imaging, with computed tomography being a primary tool.

Purpose of the Study:

• To present a case of SMAS in a young patient with an eating disorder.
• To highlight the diagnostic and therapeutic challenges of SMAS.
• To emphasize the efficacy of laparoscopic duodenojejunostomy as a surgical intervention.

Main Methods:

• A 20-year-old female patient with a history of eating disorder presented with symptoms consistent with SMAS.
• Computed tomography confirmed a significantly reduced aortomesenteric angle (15°) and distance (4 mm).
• Following failure of conservative management, the patient underwent a laparoscopic duodenojejunostomy.

Main Results:

• The patient experienced excellent postoperative outcomes.
• Hospital discharge was achieved on postoperative day 5.
• Laparoscopic duodenojejunostomy proved to be a reliable and minimally invasive solution.

Conclusions:

• SMAS presents diagnostic and therapeutic challenges due to its rarity and nonspecific symptoms.
• Nutritional rehabilitation is the cornerstone of initial management.
• Laparoscopic duodenojejunostomy is the preferred surgical option for refractory cases.