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Revista Colombiana de Cirugía

Print version ISSN 2011-7582

Abstract

VASQUEZ-ARANGO, Jesús N.; DURAN-MELENDEZ, Miguel A.  and  VASQUEZ-MAYA, Camilo. Minimally invasive management of Wilkie's syndrome. rev. colomb. cir. [online]. 2018, vol.33, n.3, pp.299-306. ISSN 2011-7582.  http://dx.doi.org/10.30944/20117582.75.

Introduction:

Compression of the third portion of the duodenum due to an inappropriate angle of the aorta-mesenteric junction is known as the superior mesenteric artery syndrome or Wilkie's syndrome. A rare entity, reason why the reports in the literature are scarce and the minimally invasive surgical management is scarcely used.

Materials and methods:

A non-systematic review of the literature was carried out, and the case of a patient with Wilkie's syndrome is reported. The images, tomographies and a video of the surgical procedure are presented.

Discussion:

The surgical management of the superior mesenteric artery syndrome is the ultimate management to be offered in patients with this entity. Duodenojejunostomy is the procedure with the best evidence to be offered to patients with severe malnutrition. The essential points of this technique, used for the case reported, are described.

Conclusions:

Any entity that causes the reduction of the fatty pack between the superior mesenteric artery and the aorta can cause superior mesenteric artery syndrome. The diagnosis is made by exclusion and constitutes a challenge for the medical team. The initial treatment is conservative, and the last option is the surgical management, ideally laparoscopic; among the minimally invasive techniques, duodenojejunostomy is a good tool.

Keywords : superior mesenteric artery syndrome; Wilkie's syndrome; duodenal obstruction; minimally invasive surgical procedures; anastomosis, surgical.

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