2022, Number 1
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Revista Cubana de Cirugía 2022; 61 (1)
Managment of a Patient with a Diagnosis of Wilkie Syndrome
Hernández OY, Galiano GJM, Oharriz GÁM, Hernández GR
Language: Spanish
References: 13
Page: 1-8
PDF size: 340.22 Kb.
ABSTRACT
Introduction:
Wilkie syndrome is a rare cause for upper intestinal obstruction, due to a compression of the duodenum between the abdominal aorta and the superior mesenteric artery, of difficult preoperative diagnosis. Barium study and arteriography are the gold-standard diagnostics. Conservative management has been preferred in individuals with short time of evolution. However, those with chronic disease usually require correction by surgical intervention.
Objective:
To present the management of a patient diagnosed with Wilkie syndrome.
Case report:
A 57-year-old male patient with emetic syndrome and weight loss of more than three months of evolution. Gastroduodenoscopy showed dilatation of the second duodenal portion due to probable extrinsic compression, while the contrast series revealed stop at the duodenojejunal junction. A transmesocolic latero-lateral duodenojejunostomy was performed, without neighboring drainage and with favorable evolution.
Conclusions:
A high index of suspicion is required for an accurate diagnosis of this entity. Duodenojejunostomy is the surgical procedure that offers the best outcomes.
REFERENCES
Salem A, Al Ozaibi L, Nassif SMM, Osman RAGS, Al Abed NM, Badri FM, et al. Superior mesenteric artery syndrome: A diagnosis to be kept in mind. Int J Surg Case Rep. 2017 [acceso 27/11/2020];34:84-6. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28376419/
Kirby GC, Faulconer ER, Robinson SJ, Perry A, Downing R. Superior mesenteric artery syndrome: a single centre experience of laparoscopic duodenojejunostomy as the operation of choice. Ann R Coll Surg Engl. 2017 [acceso 27/11/2020];99(6):472-5. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28660836/
Louie PK, Basques BA, Bitterman A, Shah S, Patel K, Abramchayev I, et al. Superior Mesenteric Artery Syndrome as a Complication of Scoliosis Surgery. Am J Orthop. 2017 [acceso 27/11/2020];46(2):E124-E30. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28437498/
Fernández López MT, López Otero MJ, Bardasco Alonso ML, Álvarez Vázquez P. Síndrome de Wilkie: a propósito de un caso. Nutr Hosp. 2011;26(3):646- 9.
Biank V, Werlin S. Superior Mesenteric Artery Syndrome in children: a 20-year experience. J Pediatr Gastroenterol Nutr. 2006;42:522-5.
Verhoef PA, Ampal A. Unique challenges for appropriate management of a 16-year-old girl with superior mesenterio artery syndrome as a result of anorexia nervosa: a case report. Journal of Medical Case Reports. 2009;3:127-31.
Merret MD, Wilson RB, Cosman P, Biankin AV. Superior Mesenteric Artery Syndrome: Diagnosis and Treatment Strategies. J Gastrointes Surg. 2009;13:287-92.
Khodear Y, Al-Ramli W, Bodnar Z. Laparoscopic management of a complicated case of Wilkie's syndrome: A case report. Int J Surg Case Rep. 2017;37:177-9.
Aslam MI, Finch JG. Prolonged gastroparesis after corrective surgery for Wilkie's syndrome. Journal of Medical Case Reports. 2008;2:109-13.
Ruiz Padilla FJ, Mostazo Torres J, Vílchez Jaimez M. Significant gastric distension caused by superior mesenteric artery syndrome or Wilkie's syndrome. Gastroenterol Hepatol. 2017. DOI: 10.1016/j.gastrohep.2017.02.010.
Albano MN, Costa Almeida C, Louro JM, Martínez G. Increase body weight to treat superior mesenteric artery syndrome. BMJ Case Rep. 2017. DOI: 10.1136/bcr-2017-219378.
Kogawa K, Kusama Y. Superior mesenteric artery syndrome in a healthy adolescent. BMJ Case Rep. 2017. DOI: 10.1136/bcr-2017-220609.
Ugras M, Bicer S, Coskun FT, Romano E, Ekci B. Superior mesenteric artery syndrome: A rare but life threatening disease. Turk J Emerg Med. 2017 [acceso 27/11/2020];17(2):70-2. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28616620/