Case Report Superior Mesenteric Artery Syndrome: An Infrequent Complication of Scoliosis Surgery Metin Keskin, 1 Turgut Akgül, 2 Adem Bayraktar, 1 Fatih Dikici, 2 and Emre BalJk 3 1 General Surgery Department, Istanbul Faculty of Medicine, Istanbul University, Capa, Millet Caddesi, 34093 Istanbul, Turkey 2 Orthopedic Department, Istanbul Faculty of Medicine, Istanbul University, Capa, Millet Caddesi, 34093 Istanbul, Turkey 3 General Surgery Department, School of Medicine, Koc ¸ University, Rumelifeneri Yolu, Sarıyer, 34450 Istanbul, Turkey Correspondence should be addressed to Emre Balık; ebalik@ku.edu.tr Received 17 August 2014; Accepted 7 October 2014; Published 22 October 2014 Academic Editor: Neil D. Merrett Copyright © 2014 Metin Keskin et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Superior mesenteric artery syndrome is a rare condition that causes a proximal small intestinal obstruction due to contraction of the angle between the superior mesenteric artery and the aorta. Scoliosis surgery is one of the 15 reasons for superior mesenteric artery syndrome, which can present with acute or chronic manifestations. Although conservative treatment is usually possible, surgical treatment is required in certain cases that cannot be treated using conservative methods. In this paper, we describe a patient who developed superior mesenteric artery syndrome ater scoliosis surgery and was treated with duodenojejunostomy due to failure and complications of conservative treatment. 1. Introduction Superior mesenteric artery (SMA) syndrome, irst deined by von Rokitansky and referred to as SMAS by Wilkie, is a rare condition resulting from increased pressure generated by contraction of the angle between the SMA and the aorta, near the third part of the duodenum [1, 2]. Approximately 15 causes have been described for SMAS; scoliosis repair surgery is one of them [3–5]. In particular, ater correction of the vertebral axis in scoliosis surgery, the angle between the SMA and the aorta can become narrow, which can cause obstruction of the duodenum [6]. SMAS can present with acute manifestations, such as a proximal small intestinal obstruction, or chronic manifestations, such as weight loss, vomiting, decreased appetite, and postprandial abdominal pain manifestations [3–5]. Conservative treatment is possible with parenteral nutrition and nasogastric tube decompres- sion [7]. However, in rare cases, the conservative methods fail, and surgical treatment is required [8–10]. his report discusses the treatment course and outcomes of a patient who developed SMAS ater scoliosis surgery and was treated with duodenojejunostomy because of the failure of conservative treatment. 2. Case Report he physical examination of a 17-year-old female patient who presented to our orthopedics polyclinic complaining of a protrusion on her back revealed kyphosis and a stooped right shoulder, a right thoracic curvature with a let-facing opening, a 6 cm high right thoracic hump on the front leaning test, and shoulder asymmetry. However, no deicits were identiied in the patient’s neurologic examination. Adolescent idiopathic thoracic scoliosis (Type 1B according to the Lenke classiication) was diagnosed via height measurements taken in the standing position [11]. In the frontal plane, the measured Cobb angles were 50 ∘ in the thoracic region and 30 ∘ in the lumbar region [12]. he patient’s bone development was classiied as Risser Grade 3. She opted for surgical treatment, and her scoliosis was corrected with global derotation; distraction and com- pression were achieved with the use of titanium polyaxial pedicle screws between the T3–L3 vertebrae in the prone position. Additionally, 60 cc allograts were placed for fusion. No abnormalities were observed during intraoperative neu- rological monitoring. he patient was observed in the inten- sive care unit for the irst 12 hours ater the surgery, and Hindawi Publishing Corporation Case Reports in Surgery Volume 2014, Article ID 263431, 5 pages http://dx.doi.org/10.1155/2014/263431