Wilkie’s Syndrome: Laparoscopic Duodenojejunostomy

Abstract

Introduction:

Superior mesenteric artery syndrome is a rare condition caused by compression of the third portion of the duodenum between the aorta and the superior mesenteric artery, usually due to an aortomesenteric angle of less than 25°. It presents with chronic abdominal pain, vomiting, early satiety, and weight loss and is more common in young women. Diagnosis is confirmed by imaging studies, primarily computed tomography.

Case Presentation:

A 20-year-old patient with a history of an eating disorder presented with chronic abdominal pain, vomiting, and weight loss. Computed tomography revealed an aortomesenteric angle of 15° and a distance of 4 mm. After failure of conservative treatment, a laparoscopic duodenojejunostomy was performed, with excellent postoperative outcomes and hospital discharge on postoperative day 5.

Discussion:

Superior mesenteric artery syndrome remains a diagnostic and therapeutic challenge due to its low prevalence and nonspecific clinical presentation. Initial management focuses on nutritional rehabilitation. When conservative treatment fails, surgical intervention is indicated. Among surgical options, laparoscopic duodenojejunostomy is the procedure of choice.

Conclusion:

This case highlights the importance of early recognition in young patients with weight loss and chronic obstructive symptoms. Laparoscopic duodenojejunostomy represents a reliable and minimally invasive surgical solution for patients who do not respond to conservative therapy.