Abstract
Superior mesenteric artery (SMA) syndrome is a rare cause of proximal bowel obstruction
in pediatric surgery. We present the management of a rare, idiopathic, and acute form
of SMA syndrome in a teenage girl, successfully treated with a robotic approach. A
14.5-year-old girl with no prior medical history and a normal body mass index (BMI)
for her age (18.4 kg/m2) was admitted to our department with acute proximal bowel obstruction syndrome. Initial
imaging, including an abdominal X-ray, computed tomography scan, and upper gastrointestinal
tract radiography, confirmed the diagnosis of SMA syndrome. Conservative management
was initiated with nasogastric tube placement, postural adjustments, and optimal nutritional
support. However, symptoms persisted, and surgery was performed 5 months after the
initiation of conservative treatment. A robotic-assisted duodenojejunostomy, preserving
the fourth portion of the duodenum, was performed without intraoperative complications.
Postoperatively, the patient experienced immediate symptom relief and was discharged
on postoperative day 4. The postoperative course and long-term follow-up (7 years)
were uneventful. This case report describes an acute, idiopathic form of SMA syndrome
successfully treated with robotic-assisted duodenojejunostomy in a teenage girl with
a normal BMI. To our knowledge, this is only the second reported case of robotic surgery
for SMA syndrome in the pediatric literature.
Keywords
superior mesenteric artery syndrome - robotic surgery - pediatric
