Superior Mesenteric Artery Syndrome – An Uncommon Complication After Surgical Corrections of Spinal Deformities

Abstract

Vascular compression of the third part of the duodenum by the superior mesenteric artery results in an unusual occlusion of the duodenal transit known as superior mesenteric artery syndrome. This syndrome can occur after surgeries to correct spinal deformities in a rate ranging from 0.5% to 4.7%. It results from a positional alteration of the artery emergency point due to a change in trunk length after surgery. It is associated with risk factors such as low body mass index and weight loss. Patients usually present with intestinal occlusion, abdominal pain, nausea, bilious vomiting, and early satiety. Superior mesenteric artery syndrome must be recognized early to institute an adequate treatment, which can be clinical (with gastric tube for decompression and nutritional support) or require a surgical procedure. Secondary complications related to superior mesenteric artery syndrome include delayed surgical and nutritional recovery, healing problems, and prolonged hospitalization. The present study aims to report a case of superior mesenteric artery syndrome in a patient with neuromuscular scoliosis secondary to a transverse myelitis who underwent surgical treatment for spinal deformity correction.

Keywords

superior mesenteric artery syndrome/complications - intestinal obstruction - spinal fusion - scoliosis/surgery

Note

Study developed at the Orthopedics Department, Rede Sarah de Hospitais de Reabilitação, Brasília, DF, Brazil.

Financial Support

There was no financial support from public, commercial, or non-profit sources.

Publication History

Received: 27 May 2020

Accepted: 16 September 2020

Article published online:
30 August 2021

• Referências

• 1 Tsirikos AI, Anakwe RE, Baker AD. Late presentation of superior mesenteric artery syndrome following scoliosis surgery: a case report. J Med Case Reports 2008; 2: 9
• 2 Rabinovitch J, Pines B, Felton M. Superior mesenteric artery syndrome. JAMA 1962; 179: 257-263
• 3 Crowther MA, Webb PJ, Eyre-Brook IA. Superior mesenteric artery syndrome following surgery for scoliosis. Spine (Phila Pa 1976) 2002; 27 (24) E528-E533
• 4 Altiok H, Lubicky JP, DeWald CJ, Herman JE. The superior mesenteric artery syndrome in patients with spinal deformity. Spine (Phila Pa 1976) 2005; 30 (19) 2164-2170
• 5 Voleti SPR, Sridhar J. Superior Mesenteric Artery Syndrome after Kyphosis Correction - A Case Report. J Orthop Case Rep 2017; 7 (05) 67-70
• 6 Bernotavičius G, Saniukas K, Karmonaitė I, Zagorskis R. Superior mesenteric artery syndrome. Acta Med Litu 2016; 23 (03) 155-164
• 7 Jalanko T, Helenius I, Pakarinen M, Koivusalo A. Gastrointestinal Complications After Surgical Correction of Neuromuscular Scoliosis: A Retrospective Cohort Study. Scand J Surg 2018; 107 (03) 252-259
• 8 Tsirikos AI, Jeans LA. Superior mesenteric artery syndrome in children and adolescents with spine deformities undergoing corrective surgery. J Spinal Disord Tech 2005; 18 (03) 263-271
• 9 Evarts CM, Winter RB, Hall JE. Vascular compression of the duodenum associated with the treatment of scoliosis. Review of the literature and report of eighteen cases. J Bone Joint Surg Am 1971; 53 (03) 431-444
• 10 Zhu ZZ, Qiu Y. Superior mesenteric artery syndrome following scoliosis surgery: its risk indicators and treatment strategy. World J Gastroenterol 2005; 11 (21) 3307-3310
• 11 Carelli LE, Schettino LC, Pedras CV, Pedras SV. Síndrome da artéria mesentérica superior após correção de deformidades vertebrais. Orthop Trauma 2004; 1: 5-10
• 12 Braun SV, Hedden DM, Howard AW. Superior mesenteric artery syndrome following spinal deformity correction. J Bone Joint Surg Am 2006; 88 (10) 2252-2257
• 13 Lenke LG, Edwards 2nd CC, Bridwell KH. The Lenke classification of adolescent idiopathic scoliosis: how it organizes curve patterns as a template to perform selective fusions of the spine. Spine (Phila Pa 1976) 2003; 28 (20) S199-S207