ArticleTrauma case reports2026
Post-traumatic superior mesenteric artery syndrome following lumbar spine stabilization: A case report and literature review.
Article in Trauma case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Superior Mesenteric Artery Syndrome (SMAS) is a rare cause of proximal intestinal obstruction resulting from compression of the third portion of the duodenum between the aorta and the superior mesenteric artery. It is most frequently reported in patients with rapid weight loss, catabolic states, or after elective spinal deformity surgery. SMAS following post-traumatic spinal stabilization is extremely uncommon and under-recognized. Case presentation: We report the case of a 17-year-old male with no significant past medical history who sustained a lumbar burst fracture (L3) after a domestic fall from a height of three stories. He underwent percutaneous pedicle screw fixation with an initially uneventful postoperative course. On postoperative day 11, he developed persistent postprandial vomiting and epigastric pain. Physical examination revealed dehydration and epigastric tenderness without peritoneal signs. Laboratory studies demonstrated mild hyponatremia and inflammatory response, with preserved renal function. Abdominal computed tomography revealed marked dilation of the stomach and proximal duodenum with a markedly reduced aortomesenteric distance (3 mm), consistent with SMAS, without evidence of intra-abdominal effusion or obstruction. A conservative management approach was implemented, including nasogastric decompression, intravenous fluid resuscitation, urinary catheterization, and close clinical monitoring. The patient's symptoms progressively resolved, and he resumed full oral intake within one week, without the need for surgical intervention. Conclusion: This case highlights that SMAS can occur even after post-traumatic spinal stabilization in otherwise healthy adolescents. Awareness of this rare complication is essential for early recognition and timely intervention. Conservative management, when instituted promptly, can be highly effective and may prevent unnecessary surgical procedures. Spine surgeons and perioperative teams should consider SMAS in the differential diagnosis of postoperative vomiting and feeding intolerance, even in post-traumatic contexts.
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