Superior mesenteric artery syndrome

The superior mesenteric artery syndrome (SMAS) is a rare complication of spine surgery. A series of four patients who experienced a SMAS after surgery for either post-traumatic quadriplegia, paraplegia or scoliosis is reported. SMAS is a condition in which the third portion of the duodenum is squeezed between the superior mesenteric artery anteriorly, and the aorta and vertebral column posteriorly. Weight loss is the major factor of development of a SMAS. Other causes include either spine surgery or trauma or application of a body cast. Delay in diagnosis may result in death. Diagnosis is obtained with either a CT scan with injection and oral contrast medium or an upper gastro-intestinal X-ray study. The latter allows the insertion of a feeding tube beyond the obstruction. A conservative treatment is started for correction of dehydration and electrolyte imbalance, and followed by nasojejunal feeding. Surgery is indicated in case of failure of conservative treatment.