WILKIES SYNDROME: CASE REPORT AND SURGICAL APPROACH IN A PATIENT WITH HIGH INTESTINAL OBSTRUCTION

Superior mesenteric artery syndrome (SMAS), also known as Wilkie s syndrome, is a rare and frequently underrecognized cause of upper intestinal obstruction. It occurs due to extrinsic compression of the third portion of the duodenum between the abdominal aorta and the superior mesenteric artery. This condition is anatomically defined by a decreased aortomesenteric angle and distance, typically resulting from significant loss of retroperitoneal fat following acute or chronic weight loss. We report the case of a 38-year-old male who presented with symptoms of high intestinal obstruction accompanied by unintentional and marked weight loss. A diagnosis of SMAS was confirmed via contrast-enhanced computed tomography (CT), which revealed a reduced aortomesenteric angle of 17 and a decreased distance of 7 mm.The patient was treated surgically through a laparoscopic duodenojejunostomy in a Roux-eY configuration, resulting in an uneventful postoperative course and satisfactory recovery. This report underscores the importance of early clinical suspicion, timely imaging, and definitive surgical intervention in the effective management of SMAS to prevent complications associated with prolonged obstruction and nutritional compromise.