Strong Procedure for Superior Mesenteric Artery Syndrome in Children: A Case Report

Superior mesenteric artery syndrome (SMAS) or Wilkie syndrome is a rare anomaly resulting from extrinsic compression of the third duodenal segment by the superior mesenteric artery (SMA) anteriorly and the abdominal aorta posteriorly. Clinically, SMAS is characterized by acute or chronic upper obstruction associated with intermittent abdominal pain. Abdominal computed tomography is the key examination for establishing the diagnosis. Although initial management is medical, surgery is required if this fails. We report the case of a 12-year-old girl admitted for acute occlusive syndrome associated with abdominal pain, in whom the diagnosis of SMAS was retained. Treatment consisted of Strong's surgical technique after failure of medical treatment with good evolution. Our case reports that in cases of SMAS where medical treatment is ineffective, less invasive surgical options such as Strong's technique may be considered to facilitate rapid recovery while minimizing the risk of complications associated with more complex procedures involving bowel resection and anastomosis.