Superior Mesenteric Artery Syndrome Following Thoracolumbar Kyphosis: Report of a Case

針對脊椎變形進行矯正手術，術後併發上腸繫膜動脈症候群，回顧相關文獻，這是一種罕見的術後併發症。本篇報告一位16歲男性脊柱後突患者，胸椎第十一節至腰椎第三節角度高達45度。於接受了脊椎矯正手術術後第二天發生噁心及間斷性含膽汁大量嘔吐，然而病患之食慾及腸音仍保持正常。經腹部電腦斷層檢查確認第十二指腸三部分受上腸繫膜動脈外在壓迫而阻塞。病患初步之治療採非手術性保守療法，包括鼻胃管引流及使用全靜脈營養，自術後第七天起，併發症獲得完全改善，病患於第十四天順利出院。回顧此病例及相關文獻，建議主要的治療方式為鼻胃管引流及靜脈輸液治療。能夠早期偵測出腸胃道阻塞臨床症狀及適切的保守治療，證實為對大部分患者有效之措施。

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並列摘要

The superior mesenteric artery syndrome is a rare complication that occurs after correction of spinal deformity. A 16-year-old male with Scheuermann kyphosis of up to 45 degrees involving the levels from T10 to L3 underwent spine correction operation. However, intermittent, voluminous, and bile-stained vomiting, and nausea developed on the 2nd post operative day, despite normal appetite and bowel sounds. A contrast-enhanced abdominal computed tomography scan confirmed the presence of extrinsic obstruction in the third part of the duodenum caused by the superior mesenteric artery. The patient was managed non-operative measures such as nasogastric tube drainage and total parenteral nutrition. The complication was resolved on the 7th postoperative day and the patient was discharged on the 14th postoperative day. The results and a literature review suggest that early recognition of the clinical signs of obstruction and proper conservative treatment can prove efficient for most cases.

並列關鍵字

Superior mesenteric artery SMA syndrome ； Kyphosis

國際替代計量

Superior Mesenteric Artery Syndrome Following Thoracolumbar Kyphosis: Report of a Case

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