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Laparoscopic Duodenojejunostomy for Superior Mesenteric Artery Syndrome
Hugh G. Auchincloss^*, Peter J. Fagenholz, Ozanan Meireles
Surgery, Massachusetts General Hospital, Boston, MA

A 21 year-old man presented with abdominal pain, vomiting and jaundice occurring 4 months after a motor vehicle accident that had left him a C6 paraplegic. In the interim he had lost 40lbs and now had a BMI of 19. On exam his abdomen was distended. His jaundice resolved with nasogastric decompression. CT scan demonstrated dilation of the stomach and proximal duodenum with a transition point at the crossing of the superior mesenteric artery. The SMA formed a 25 degree angle with the aorta, consistent with SMA syndrome. He was brought to the operating room for a laparoscopic duodenojejunostomy. His postoperative course was unremarkable and he was able to return to spinal cord rehabilitation.

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