Acta Scientific Gastrointestinal Disorders (ASGIS)(ISSN: 2582-1091)

Case Report Volume 5 Issue 12

Intestinal Obstruction Due to Duodenal Malrotation Successfully Managed by Duodeno-jejunal Derivation on Roux's Loop

Shailesh Khandekar1* and Revati Khandekar2

1Assistant Professor, General Surgery, N.Y. Tasgaokar Institute of Medical Sciences, Karjat, Maharashtra, India

2PPC MO, Brihanmumbai Municipal Corporation Hospitals, Mumbai, India

*Corresponding Author: Shailesh Khandekar, Assistant Professor, General Surgery, N.Y. Tasgaokar Institute of Medical Sciences, Karjat, Maharashtra, India.

Received: November 14, 2022; Published: November 25, 2022


Superior Mesentric Artery Syndrome (SMAS) is a rare entity due to compression of the duodenum between the SMA and Aorta. Very rarely, this syndrome can be present in a pre-existing anatomy of congenital malrotation of the duodenum. We describe case of the intestinal obstruction in a 21-year-old woman due to undiagnosed congenital duodenal malrotation presenting with SMAS. The current literature, diagnostic modalities and management options are discussed.

Keywords: Congenital Duodenal Malrotation; Superior Mesenteric Artery Syndrome; Wilkie Syndrome; Arteriomesenteric Occlusion of the Duodenum


  1. Karrer FM. “Superior Mesenteric Artery Syndrome”. Medscape Reference. January 6, (2017).
  2. Gerasimidis T and George F. “Superior Mesenteric Artery Syndrome. Wilkie Syndrome”. Digestive Surgery3 (2009): 213-214.
  3. Shiu JR., et al. “Clinical and nutritional outcomes in children with idiopathic superior mesenteric artery syndrome”. Journal of Pediatric Gastroenterology and Nutrition2 (2010): 177-82.
  4. Lee TH., et al. “Superior mesenteric artery syndrome: where do we stand today?” Journal of Gastrointestinal Surgery 16 (2012): 2203-2211.
  5. Hillyard J., et al. “Gastrointestinal: Reversal of superior mesenteric artery syndrome following pregnancy”. Journal of Gastroenterology and Hepatology3 (2019): 486.
  6. Merrett Neil., et al. “Superior Mesenteric Artery Syndrome: Diagnosis and Treatment Strategies”. Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract 13 (2008): 287-292.
  7. Kyslan K., et al. “Superior mesenteric artery (SMAS/AMS) syndrome and its management”. Rozhl Chir.5 (2008): 255-258.
  8. Wilson-Storey D and MacKinlay GA. “The superior mesenteric artery syndrome”. The Royal College of Surgeons of Edinburgh 3 (1986): 175-178.
  9. Gudumac E., et al. “Ocluzii duodenale cronice la copii. Probleme de diagnostic și tratament. [Chronic duodenal occlusions in children. Diagnostic and treatment problems]”. Analele Ştiinţifice (Asociaţia Chirurgilor Pediatri Universitari din RM) Numărul XVIII (2013): 4-7.
  10. Bauer Adalbert. “Subocluzia duodenală intermitentă la copii. Studiu clinic și radiologic [Intermittent duodenal subocclusion in children. Clinical and radiological study]”. Revista Corpului Medical Sătmărean. Publicată de Colegiul Medicilor SatuMare. A 4-a ediţie a Zilelor Medicale Sătmărene, 4-6 octombrie (2007): 4-9.
  11. Zaraket V and Deeb L. “Wilkie's Syndrome or Superior Mesenteric Artery Syndrome: Fact or Fantasy”. Case Reports in Gastroenterology 9 (2015): 194-199.
  12. Gwee K., et al. “Acute superior mesenteric artery syndrome and pancreatitis in anorexia nervosa”. Australas Psychiatry6 (2010): 523-526.
  13. Rui Zhang., et al. “Diagnosis and treatment of superior mesenteric artery compression syndrome complicated with gastroesophageal reflux disease”. Chinese Medical Journal11 (2021): 1382-1384.
  14. Ganss A., et al. “Superior Mesenteric Artery Syndrome: a Prospective Study in a Single Institution”. Journal of Gastrointestinal Surgery 5 (2019): 9971005.
  15. Silva G., et al. “Iatrogenic superior mesenteric artery syndrome”. Revista Espanola de Enfermedades Digestivas 11 (2018): 742-743.
  16. Young A., et al. “Intermittent superior mesenteric artery syndrome in a patient with multiple sclerosis”. Radiology Case Reports 6 (2016): 1108-1111.
  17. Van Horne N and Jackson JP. “Superior Mesenteric Artery Syndrome”. [Updated 2021 Jul 21]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; (2022).
  18. Naseem Z., et al. “"Less is more": Non operative management of short term superior mesenteric artery syndrome”. Annals of Medicine and Surgery (Lond).4 (2015): 428-430.
  19. Mandarry MT., et al. “A comprehensive review of superior mesenteric artery syndrome”. European Surgery 42 (2010): 229-236 .
  20. Ha CD., et al. “Duodenal derotation as an effective treatment of superior mesenteric artery syndrome: a thirty-three year experience”. American Surgery 7 (2008): 644-653.
  21. Pottorf BJ., et al. “Laparoscopic management of duodenal obstruction resulting from superior mesenteric artery syndrome”. JAMA Surgery12 (2014): 1319-1322.
  22. Kirby GC., et al. “Superior mesenteric artery syndrome: a single centre experience of laparoscopic duodenojejunostomy as the operation of choice”. Annals of The Royal College of Surgeons of England 6 (2017): 472-475.
  23. Valiathan G., et al. “A Case Series on Superior Mesenteric Artery Syndrome Surgical Management, Single Institution Experience”. Journal of Clinical and Diagnostic Research 8 (2017): PR01-PR03.


Citation: Shailesh Khandekar and Revati Khandekar. “Intestinal Obstruction Due to Duodenal Malrotation Successfully Managed by Duodeno-jejunal Derivation on Roux's Loop". Acta Scientific Gastrointestinal Disorders 5.12 (2022): 32-36.


Copyright: © 2022 Shailesh Khandekar and Revati Khandekar. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate35%
Acceptance to publication20-30 days

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is June 25, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US