Journal of the Formosan Medical Association
Volume 106, Issue 2, Supplement , Pages S37-S45, 2007

Superior Mesenteric Artery Syndrome Complicating Staged Corrective Surgery for Scoliosis

  • Chee-Huan Pan

      Affiliations

    • Department of Orthopedics and Traumatology, Hospital Kangar, Perlis, Malaysia, Taiwan
    • ,
  • Shiau-Tzu Tzeng

      Affiliations

    • Division of Orthopedics, Buddhist Tzu-Chi General Hospital, Taipei Branch, Taiwan
    • ,
  • Chiang-Sang Chen

      Affiliations

    • Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei, Taiwan
    • ,
  • Po-Quang Chen

      Affiliations

    • Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Po-Quang Chen, Department of Orthopedic Surgery, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan

Received 18 November 2005; received in revised form 22 December 2005; accepted 4 April 2006.

Article Outline

Superior mesenteric artery syndrome (SMAS) is a rare complication following correction of scoliosis with either nonoperative or operative methods. If the patient diagnosed with this syndrome is not managed timely and adequately, mortality may result. We report two cases of SMAS complicating staged corrective surgery for scoliosis using modern segmental derotation instrumentation system. The aim of this report is to highlight the clinical presentations, laboratory findings, radiologic features, and management of the syndrome. The first patient had the syndrome after two-staged scoliosis surgery with halo traction between two stages, and the second patient after three-staged scoliosis surgery with halo traction between the first and second surgeries. The first patient responded well to conservative treatment. However, the second patient failed to respond to conservative treatment and needed a gastrojejunostomy operation to bypass the duodenal obstruction. Clinicians treating post scoliosis surgery patients should always have a high index of suspicion for this potential life-threatening condition. Early diagnosis will enable a multidisciplinary team approach to be initiated early to provide optimal care for the patient. Nutritional and fluid supplementation is mandatory during conservative treatment. The duration for trial of conservative treatment should not exceed 1 week. [J Formos Med Assoc 2007;106(2 Suppl):S37-S45]

Key Words:  ileus , scoliosis , superior mesenteric artery syndrome

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PII: S0929-6646(09)60351-X

doi:10.1016/S0929-6646(09)60351-X

Journal of the Formosan Medical Association
Volume 106, Issue 2, Supplement , Pages S37-S45, 2007

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