Laparoscopic duodenojejunostomy for recurrent acute pancreatitis associated with superior mesenteric artery syndrome in a medically complex patient: A case report and literature review
Abstract
Rationale: Superior mesenteric artery syndrome (SMAS) is a rare cause of duodenal obstruction, and acute pancreatitis associated with SMAS is extremely uncommon. The causal relationship is usually inferred from persistent duodenal obstruction, exclusion of other etiologies, and resolution after decompression.
Patient concerns: A 19-year-old male with a history of esophageal atresia repair, previous upper abdominal surgery, refractory epilepsy, severe developmental delay, and a bedridden status presented with recurrent vomiting and acute pancreatitis. Pancreatitis recurred over a period of 4 years despite repeated conservative management and eventually increased to approximately once per month.
Diagnoses: Contrast-enhanced computed tomography revealed marked gastric and duodenal dilation, compression of the third portion of the duodenum between the aorta and the superior mesenteric artery, and a narrowed aortomesenteric angle of 18°. Other causes of pancreatitis, including gallstones, pancreaticobiliary maljunction, and infection, were excluded. Recurrent acute pancreatitis associated with SMAS-related duodenal obstruction was diagnosed.
Interventions: Conservative treatment included bowel rest, nasogastric decompression, intravenous fluid and electrolyte correction, and prokinetic medication. Because recurrent pancreatitis persisted, laparoscopic duodenojejunostomy with omega-loop reconstruction was performed at age 23. Dense intra-abdominal adhesions precluded safe…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- eggNOG 5.0: a hierarchical, functionally and phylogenetically annotated orthology resource based on 5090 organisms and 2502 viruses
- Online Survival Analysis Software to Assess the Prognostic Value of Biomarkers Using Transcriptomic Data in Non-Small-Cell Lung Cancer
- OptiType: precision HLA typing from next-generation sequencing data
- Nicotinic Cholinergic System and COVID-19: In Silico Identification of an Interaction between SARS-CoV-2 and Nicotinic Receptors with Potential Therapeutic Targeting Implications
- Saccharomyces cerevisiae cells have three Omega class glutathione S-transferases acting as 1-Cys thiol transferases
- Hemolysis at low blood flow rates: in-vitro and in-silico evaluation of a centrifugal blood pump
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.