Martínez H, Martínez S, Sánchez-Ussa S, Pedraza M, Cabrera LF

Language: Spanish
References: 20
Page: 22-27
PDF size: 468.92 Kb.

ABSTRACT

Introduction: Wilkie’s syndrome is a rare entity that presents as a chronic intestinal obstruction secondary to mechanical compression of the third portion of the duodenum due to a decreased aorto-mesenteric angle. This entity has a reported incidence of 0.012 to 2.4% and can lead to high morbidity and mortality; In addition, there are major controversies regarding its diagnosis and treatment, which is why the authors present a case report of a patient with a diagnosis of Wilkie's syndrome and its surgical management via laparoscopy. Methods: A case of a patient with clinical and imaging manifestations of superior mesenteric artery syndrome is presented, along with acritical review of the literature, taking into account articles published in the PubMed and ScienceDirect databases during the past 8 years. Clinical case: A 27-year-old patient with 20 years of abdominal pain that exacerbated one week before admission, with a clinical and imaging manifestations of Wilkie’s syndrome. Patient presents refractoriness to medical management, which led to a surgical approach with laparoscopic duodenum-jejunostomy that was carried out without perioperative complications and satisfactory results. Discussion and conclusions: The superior mesenteric artery syndrome is a rare entity that in some scenarios requires surgical management. The laparoscopic duodeno-jejunostomy is the procedure of choice to manage this entity as evidenced in our case, which is also consistent with what is reported in the world medical literature.

REFERENCES

1. Aneiros Castro B, Cano Novillo I, García Vázquez A, Martín Alelu R, Gómez Fraile A. Wilkie’s syndrome in monozygotic twins treated by 3-D laparoscopic duodenojejunostomy. Asian J Endosc Surg. 2018 Apr 19. doi: 10.1111/ases.12489.

2. Catarino Santos S, Loureiro AR, Simão R, Pereira J, Pinheiro LF, Casimiro C. Wilkie’s syndrome: a case report of favourable minimally invasive surgery. J Surg Case Rep. 2018;2018(2) rjy027. doi: 10.1093/jscr/rjy027.

3. 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: 177-179. doi: 10.1016/j.ijscr.2017.06.033.

4. Makary MS, Rajan A, Aquino AM, Chamarthi SK. Clinical and radiologic considerations for idiopathic superior mesenteric artery syndrome. Cureus. 2017;9(11):e1822. doi: 10.7759/cureus.1822.

5. Oguz A, Uslukaya O, Ülger BV, Turkoglu A, Bahadır MV, Bozdag Z, et al. Superior mesenteric artery (Wilkie’s) syndrome: a rare cause of upper gastrointestinal system obstruction. Acta Chir Belg. 2016;116(2):81- 8. doi: 10.1080/00015458.2016.1139830.

6. Konstantinidis H, Charisis C, Kottos P. Robotic Strong’s procedure for the treatment of superior mesenteric artery syndrome. Description of surgical technique on occasion of the first reported case in the literature. Int J Med Robot. 2018;14(1). doi: 10.1002/rcs.1876.

7. Farina R, Foti PV, Cocuzza G, Costanzo V, Costanzo G, Conti A, et al. Wilkie’s syndrome. J Ultrasound. 2017;20(4):339-342. doi: 10.1007/s40477-017-0257-2.

8. Kaur A, Pawar NC, Singla S, Mohi JK, Sharma S. Superior mesentric artery syndrome in a patient with subacute intestinal obstruction: a case report. J Clin Diagn Res. 2016; 10(6): 03–05. doi: 10.7860/JCDR/2016/19699.7932.

9. Ruiz Padilla FJ, Mostazo Torres J, Vílchez Jáimez M. Significant gastric distension caused by superior mesenteric artery syndrome or Wilkie’s syndrome. Gastroenterol Hepatol. 2017;40(8):581-583. doi: 10.1016/j gastrohep 2017.02.010.

10. Bhattacharjee PK. Wilkie’s syndrome: an uncommon cause of intestinal obstruction. Indian J. Surg. 2008;70: 83-85.

11. Zaraket V, Deeb L. Wilkie’s Syndrome or superior mesenteric artery syndrome: fact or fantasy? Case Rep Gastroenterol. 2015;9(2):194-9. doi: 10.1159/000431307.

12. Barquín Yagüez J, Abadía Barnó P, García Pérez JC. Superior mesenteric artery syndrome: an uncommon cause of intestinal obstruction. Rev Esp Enferm Dig. 2017;109(1) 60.

13. Fraser JD, St Peter SD, Hughes JH, Swain JM. Laparoscopic duodenojejunostomy for superior mesenteric artery syndrome. JSLS. 2009;13(2):254-9.

14. Kefeli A, Aktürk A, Aktaş B, Çalar K. Wilkie’s syndrome: a rare cause of intestinal obstruction. Arq Bras Cir Dig. 2016;29(1) 68. doi: 10.1590/0102- 6720201600010020.

15. 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;99(6):472-475. doi: 10.1308/rcsann.2017.0063.

16. Zachariah SK. Wilkie’s syndrome: a rare cause of intestinal obstruction. MJ Case Rep. 2014;2014. pii: bcr2013203059. doi: 10.1136/bcr-2013-203059.

17. Fearon NM, Mohan HM, Winter DC. Wilkie’s syndrome causing persistent vomiting post-colectomy. Int J Surg Case Rep. 2013;4(12):1071-2. doi: 10.1016/j ijscr 2013.09.004.

18. Ayloo SM1, Masrur MA, Bianco FM, Giulianotti PC. Robotic Roux-en-Y duodenojejunostomy for superior mesenteric artery syndrome: operative technique. J Laparoendosc Adv Surg Tech A. 2011;21(9):841-4. doi: 10.1089/lap 2011.0070.

19. Fraser JD, St Peter SD, Hughes JH, Swain JM. Laparoscopic duodenojejunostomy for superior mesenteric artery syndrome. JSLS. 2009;13(2):254-9.

20. Mathenge N, Osiro S, Rodriguez II, Salib C, Tubbs RS, Loukas M. Superior mesenteric artery syndrome and its associated gastrointestinal implications. Clin Anat. 2014;27(8):1244-52. doi: 10.1002/ca.22249.