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2007, Number 2

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Acta Pediatr Mex 2007; 28 (2)

Vascular duodenal compression in a neonate

Alvarado-García R, Ponce-Rosas A, García-Sánchez D, Gallego-Grijalva JE

Language: Spanish
References: 28
Page: 69-73
PDF size: 151.44 Kb.


ABSTRACT

Intestinal obstruction by compression of the mesenteric artery is rare in the newborn. We describe the case of a two days old neonate with a double bubble image in the simple abdominal radiograph and the ultrasound. The diagnosis was made during a laparotomy, when significant dilatation of the first and second duodenal portions was found, caused by a superior mesenteric artery with an abnormal course, which was displaced downwards and anterior to the vertebral column; abundant fibrous tissue surrounded the duodenum, and the renal artery; there was an attachment of the Treitz ligament and a narrow root of the mesentery. The third portion of the duodenum was released and a duodenoyeyunal anastomosis was performed. At this age a conservative management is not justified, as it is in adult patients in whom nasogastric decompression, fluid therapy, replacement of electrolytes, gastrokinetics, and hyperalimentation are implemented. We believe surgical treatment is mandatory in every case.


REFERENCES

  1. Androulakis J, Colborn GL, Skandalakis PN. Surgical anatomy and embryology.Embryologic and anatomic basis of duodenal surgery. Surg Clin North Am 2000;8(1):171-99.

  2. Hines JR, Gore R, Ballantyne GH. Superior mesenteric artery syndrome. Diagnostic criteria and therapeutic approaches. Am J Surg 1984;148:630-2.

  3. Gustafsson L, Kalk A, Lukes PJ. Diagnosis and treatment of superior mesenteric artery syndrome. Br J Surg 1984;71:499-500.

  4. Dietz UA, Debus ES, Heuko-Valiati L. Mesenteric artery compression syndrome. Chirurg 2000;71(11):1345-51.

  5. Valle E, Goyanes A,Muñiz J. Compresión vascular del duodeno. Rev Esp Enf Ap Digest 1984;65:41-6.

  6. Sözübir S, Kahraman H, Arslan A, Ekingen G, Güvenç BH. Incomplete duodenal obstruction in a newborn. Indian J Pediatr 2006;73(4):364-6.

  7. García J, Pérez A, Sánchez R. Síndrome de la arteria mesentérica superior. Cir Gen 2000;22(4):347-50.

  8. Androulakis J, ColbornGL, Skandalakis PN, Skandalakis LJ, Skandalakis JE. Embryologic and anatomic basis of duodenal surgery. Surg Clin North Am 2000;80(1):171-99.

  9. Feldman M, Weinberg T. Aberrant pancreas: Cause of duodenal syndrome. JAMA 1952;148:893.

  10. Mishalany H, Olson A, Khan F. Deficient neurogenic innervation of the myenteric plexus with normal submucous plexus involving the entire small and large bowel. J Pediatr Surg 1989;24:83.

  11. Eggert A, Teichmann W, Whitmann DH. The pathologic implication of duodenal diverticula. Surg Gynecol Obstet 1982;154:62.

  12. Gutiérrez C, Gonzálvez J, Pérez A. Síndrome de arteria mesentérica superior: Una causa infrecuente de obstrucción duodenal en la infancia. An Esp Pediatr 1996;45:289-90.

  13. Sánchez-Lozada R, Acosta-Rosero AU, Balas-Salame C. Síndrome de la arteria mesentérica superior como causa de intolerancia parcial crónica a la alimentación oral. Reporte de un caso y revisión del tema. Rev Gastroenterol Mex 2002;67(1):38-42.

  14. Shetty A, Schmidt-Sommerfeld E, Haymon ML. Radiological case of the month. Superior mesenteric artery syndrome. Arch Pediatr Adolesc Med 1999;153:303-4.

  15. Chehab F. Superior mesenteric artery syndrome in adults. Ann Chir 2001;126(8):808-10.

  16. Diwakaran HH. Superior mesenteric artery syndrome. Gastroenterology 2001;121(3):516-746.

  17. Akien JT Jr, Skandalakis JE, Gray SW. The anatomic basis of vascular compression of the duodenum. Surg Clin North Am 1974;54(3):1361-70.

  18. Fuentes J, Sebastián JJ, Martín ML, Manero S, Uribarrena R. Técnicas de imagen en la pinza aorto-mesentérica. Rev Esp Enferm Dig 1997;89(12):934.

  19. Ghosh A. Superior mesenteric artery syndrome causing acute intestinal obstruction. J Assoc Physicians India 2000;48(8):847-8.

  20. Baltazar U. Superior mesenteric artery syndrome: An uncommon cause of intestinal obstruction. South Med J 2000;93(6):606-8.

  21. Battilana A, Crespi B, Rabughino G. Two cases of duodenal vascular compression syndrome. Minerva Med 1989;80(8):815-20.

  22. Cogliandolo A, Certo A, Bottari M. Vascular compression syndrome of the duodenum. Diagnostic and therapeutic update. Ann Ital Chir 1989;60(6):531-5.

  23. Gasbarro V, Schettino AM, Chiozzi A. Aorto-mesenteric compression syndrome. Description of clinical case and critical review of the literature. Minerva Chir 1999;54(5):335-8.

  24. Leutloff UC, Eislod S, Schenk JP. Obstruction in the duodenal passage. Mesenteric artery duodenal compression. Radiology 2000;40(1):83-5.

  25. Applegate GR, Cohen AJ. Dynamic CT in superior mesenteric artery syndrome. J Comput Assist Tomogr 1988;12:976-80.

  26. Gersin KS, Heniford BT. Laparoscopic duodenojejunostomy for treatment of superior mesenteric artery syndrome. J Soc Laparoendos Surg 1998;8:281-4.

  27. Richardson WS, Surowiee WJ. Laparoscopic repair of superior mesenteric artery syndrome. Am J Surg 2001;181(4):377-8.

  28. Lima HS, Maia Am, Castro Neto AKP. Síndrome da arteria mesentérica superior. Rev Col Bras Cir 2000;27(2):131-3.




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