Superior Mesenteric Artery Syndrome After Laparoscopic Low Anterior Resection

Abstract

Superior mesenteric artery syndrome (SMAS) is an uncommon cause of duodenal obstruction due to the extrinsic compression of the third part of the duodenum by the superior mesenteric artery (SMA) as it passes anterior to it. We present a case of a 70-year old lady with abdominal pain, postprandial vomiting and decreased oral intake following laparoscopic low anterior resection with endoscopic and radiological findings suggesting SMAS. The cause was the traction on the transverse mesocolon and the middle colic artery to place the transverse colon in the deep pelvis. This, in turn, has lead to traction and flattening of the SMA against the aorta causing SMAS. The patient was successfully managed conservatively with enteral feeding and surgery was avoided.