A Delayed Presentation of Superior Mesenteric Artery Syndrome Treated With Robotic-Assisted Strong Procedure

Superior mesenteric artery (SMA) syndrome, also known as Wilkie's syndrome, is a rare condition resulting from compression of the third portion of the duodenum between the aorta and the superior mesenteric artery. When symptomatic, this compression may result in nausea, vomiting, epigastric discomfort, and weight loss, requiring clinical attention and imaging to make the diagnosis. Typically, SMA syndrome presents in young females and is associated with an underlying condition such as anorexia nervosa, cachexia, postoperative development after scoliosis surgery, etc. In this report, we present the case of an atypical delayed presentation of SMA syndrome in an 84-year-old male who had epigastric pain, nausea, intermittent vomiting, and a 30-pound weight loss over two years. SMA syndrome was diagnosed on a computed tomography (CT) scan by a decreased angle between the superior mesenteric artery and abdominal aorta, and treatment with a robotic-assisted strong procedure was performed. The patient was followed postoperatively in the clinic and tolerated the procedure well.