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CASE REPORT
A case report of a 13-year-old girl diagnosed with superior mesenteric artery syndrome after
undergoing spine correction with posterior fusion for rapidly progressed juvenile idiopathic scoliosis
1
Department of Trauma and Orthopaedic, Regional Specialized Children's Hospital in Olsztyn, Poland
2
Department of General Surgery, Vascular Surgery and Transplantology, Regional Specialized Hospital in Olsztyn, Poland
3
Department of Radiotherapy, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
Submission date: 2016-01-18
Acceptance date: 2016-02-23
Online publication date: 2016-03-16
Publication date: 2020-03-24
Corresponding author
Paweł Grabala
Department of Trauma and Orthopaedic, Regional Specialized Children's Hospital, Żołnierska 18A, 10-561 Olsztyn, Poland. Tel.: +48 89 675 51 13/787 111 100; fax: +48 77 546 63 24.
Department of Trauma and Orthopaedic, Regional Specialized Children's Hospital, Żołnierska 18A, 10-561 Olsztyn, Poland. Tel.: +48 89 675 51 13/787 111 100; fax: +48 77 546 63 24.
Pol. Ann. Med. 2016;23(2):165-171
KEYWORDS
ABSTRACT
Introduction:
Superior mesenteric artery (SMA) syndrome (SMAS) is a relatively rare disease that the etiology is closely related to the anatomy and the topography of the duodenum, aorta, and SMA.
Aim:
To present and analyze the case of a patient who was diagnosed and treated for SMAS after scoliosis surgery.
Case study:
A 13-year-old girl was admitted to our department for the surgical treatment of juvenile idiopathic scoliosis, with a Cobb angle of 1208 in the main curvature. Postoperatively, we obtained the expected correction of 50%. Interestingly, after the treatment, BMI changed from 19 to 16, which assigned the patient to the underweight, starvation and emaciation group.
Results and discussion:
On the 5th postoperative day, the patient's condition deteriorated. She suffered from abdominal pain, nausea and vomiting. We diagnosed SMAS. After conservative treatment the patient's condition improves and she was discharged from the hospital on the 16th postoperative day in a good general condition after the complete resolution of SMAS symptoms.
Conclusions:
(1) SMAS can occur frequently in patients after surgical correction of the spine deformities. (2) At the curvatures of the order of 1008–1208 or more, there is a significant change in the topography of the anatomical structures and their adaptation to a new position after surgery. (3) Special attention must be paid to young, lean patients, with BMI below 19, and the postoperative effect of an elongated axis of the spine. (4) Even if SMAS occurs, in most cases it can and should be treated conservatively.
Superior mesenteric artery (SMA) syndrome (SMAS) is a relatively rare disease that the etiology is closely related to the anatomy and the topography of the duodenum, aorta, and SMA.
Aim:
To present and analyze the case of a patient who was diagnosed and treated for SMAS after scoliosis surgery.
Case study:
A 13-year-old girl was admitted to our department for the surgical treatment of juvenile idiopathic scoliosis, with a Cobb angle of 1208 in the main curvature. Postoperatively, we obtained the expected correction of 50%. Interestingly, after the treatment, BMI changed from 19 to 16, which assigned the patient to the underweight, starvation and emaciation group.
Results and discussion:
On the 5th postoperative day, the patient's condition deteriorated. She suffered from abdominal pain, nausea and vomiting. We diagnosed SMAS. After conservative treatment the patient's condition improves and she was discharged from the hospital on the 16th postoperative day in a good general condition after the complete resolution of SMAS symptoms.
Conclusions:
(1) SMAS can occur frequently in patients after surgical correction of the spine deformities. (2) At the curvatures of the order of 1008–1208 or more, there is a significant change in the topography of the anatomical structures and their adaptation to a new position after surgery. (3) Special attention must be paid to young, lean patients, with BMI below 19, and the postoperative effect of an elongated axis of the spine. (4) Even if SMAS occurs, in most cases it can and should be treated conservatively.
FUNDING
This work was financed by own funds of all authors.
CONFLICT OF INTEREST
None declared.
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