University of California, USA
Maha Alkhuziem has completed her Medical education at the age of 25 years from King Abdulaziz University and currently doing her Master of advanced science in clinical research at UC San Diego. She has published more than 3 papers in reputed journals and has been serving as a surgical teaching assistant at King Abdulaziz University and a researcher at UC San Diego. His main research interest is focused on patient’s centered and reported outcomes researches.
Introduction: Superior Mesenteric Artery (SMA) syndrome is a rare conditionin which the SMA compresses the third portion of the duodenum. The following are the first two SMA syndrome cases to be reported in Saudi Arabia. Roux En Y anastomosis or Lateral Doudenojejunostomy is used to treat this syndrome surgically. Yet, this is the first timeto use laparoscopic Omega loop (Lateral Doudenojejunostomy) with Braun anastomosis (Jejunojejunostomy) for treating this syndrome.
Case 1: A 24-year-old woman was presented with 4 years history of vague abdominal pain mainly at the epigastric region, associated with repeated vomiting. The patient had also lost significant weight during the last six months. SMA syndrome was confirmed using CT scan and fluoroscopy. The patient was planned for laparoscopic Omega loop with Braun anastomosis as treatment.
Case 2: A 19-year-old woman was presented with 2 days history of severe recurrent emesis and vague abdominal pain. Six weeks prior to her presentation, she had been diagnosed with SMA syndrome using CT and fluoroscopyin another hospital, where Laparoscopic Lateral Doudenojejunostomy was preformed. We performed Braun anastomosis later on in order to connect the two limbs of the Omega loop that had been created by the previous team.
Outcome: Both patients were followed up for six months. They gained weight and were doing well.
Conclusion: To our knowledge laparoscopic Omega loop with Braun anastomosis (double drainage) is the most appropriate surgical management of SMA syndrome in comparison to Roux En Y anastomosis or Lateral Doudenojejunostomy as our experience showedsuccessful outcome.