LaparoscopicManagement of Duodenal Obstruction Resulting From Superior Mesenteric Artery Syndrome

S uperior mesenteric artery (SMA) syndrome is a rare disease that causes compression of the third portion of the duodenum. Current definitions focus on the mechanical obstruction secondary to compression of the third portion of the duodenum by the SMA anteriorly and the aorta and vertebral column posteriorly.1 The duodenal compression often manifests as a sense of fullness in the epigastrium, postprandial abdominal pain, early satiety, and intermittent emesis.1-7 Although nonoperative medical management is often attempted as the initial treatment modality, surgical intervention can be required for bypass of the obstruction.2 Open duodenojejunostomy remains the standard operation for SMA syndrome.1-5 A minimally invasive approach to treating SMA syndrome, developed from bariatric surgery techniques, now offers an alternative to traditional laparotomy.