A Case Report of Superior Mesenteric Artery Syndrome after abdominoperineal Excision of Rectal Cancer

Tatsunori Hamasaki¹⁾, Naohide Mori²⁾, Kenji Wadamori³⁾ and Masaaki Oka²⁾

¹⁾Department of Surgery National Yamaguchi Hospital
²⁾Department of Surgery II Yamaguchi University
³⁾Department of Surgery Ogori Daiici Sogo-Hospital

We experienced a case of superior mesenteric artery syndrome (SMAS) as a post-operative complication after abdominoperineal excision for rectal cancer in 65-year-old man. Duodenal compression by the overlying superior mesenteric artery may be caused by strong traction of the mesenterium to the pelvic floor which was made by postoperative adhesion. Although the mobilization of the third part of the duodenum was performed, the symptoms reappeared 3 months after surgery. Therefore, we performed side-to-side duodenojejunostomy. The patient has continued to make satisfactory progress 8 years after the reoperation. SMAS should be considered as a postoperative ompliation after abdominal surgery, although it may be rare. Side-to-side duodenojejunostomy may be recommended.

Key words
superior mesenteric artery syndrome, duodenojejunostomy, abdominoperineal excision

Reprint requests
Tatsunori Hamasaki Department of Surgery, National Yamaguchi Hospital 7-3 Kogushi, Toyoura, Yamaguchi, 759-6302 JAPAN

Accepted
July 28, 1999

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