Abstract
A 77-year-old female was admitted to our hospital complaining abdominal bloating and appetite loss. Abdominal X-ray showed marked distension of the stomach and duodenum. Abdominal ultrasonography demonstrated the aorto-mesenteric angle of 24 degrees. The distance between SMA and aorta, at the location where the duodenum passed from, was 6mm on CT. SMA syndrome was diagnosed. Laparoscopic duodenojejunostomy was performed. A 12mm port was inserted through the umbilicus for videoscope. Next, a left lower quadrant 12mm port and a left upper quadrant 5mm port was placed. Stab wounds were made with cautery on the third part of the duodenum and on the jejunum 30cm distant from the ligament of Treitz to introduce a cutting linear stapler (Endo-GIATM Tri-StapleTM). The stab wounds were stapled shut with a cutting linear stapler. The duration of procedure was 91 minutes. The postoperative course was uneventful. She could have meals on ninth postoperative day and returned previous hospital on 20th. Laparoscopic duodenojejunostomy would be considered a easier, less invasive, and more effective procedure for treating SMA syndrome.
