Wilkie's Syndrome in a second surgical approach

Wilkie’s Syndrome, or superior mesenteric artery (SMA) syndrome is a rare disease defined as compression of the third part of the duodenum between the aorta and superior mesenteric artery. Treatment consists initially in conservative measures and surgical therapy is indicated in cases of failure. Duodenojejunostomy and release of the Treitz’s ligament (Strong’s procedure) are the surgical procedures described in the literature. We report the case of a 30-year-old man with upper digestive obstruction symptoms. The patient had a previous billroth II gastro-entero anastomosis with Braun enteroenterostomy but with poor symptom relief in the postoperative period. Given the patient’s symptoms and an abdominal computed tomography showing important duodenal and gastric dilatation due to an angulation reduction in the emergence of the superior mesenteric artery and the compression of the third portion of the duodenum an exploratory laparotomy with jejunum-duodenum anastomosis was performed. This article presents a case report and review of literature of this entity.