Summary
Vascular compression of the duodenum, the so-called cast syndrome, which is due to the mechanical compression of the third part of the duodenum from the superior mesenteric artery, was developed post-operatively in six patients treated for their spine deformities. The early recognition of the clinical signs of the obstructive ileus and the proper conservative treatment proved efficient for five of the patients, and only in one laparotomy and duodeno-jejunostomy were inevitable due to the severity and persistency of the symptoms.
The purpose of this report is to record these cases describing the clinical manifestations, the treatment, and the pathogenesis of the vascular compression of the duodenum which may occur during the treatment of the spine deformities.
Zusammenfassung
Die vaskuläre Kompression des Duodenums (Castsyndrom, bedingt durch eine Druckeinwirkung der Hauptmesenterialarterie auf den unteren Duodenalabschnitt) führte postoperativ bei sechs wegen spinaler Mißbildungen operierter Patienten zur Entwicklung einer Ileussymptomatik. Durch frühe Einleitung konservativer Maßnahmen konnten fünf Patienten erfolgreich behandelt werden. Lediglich in einem Fall wurde eine operative Revision notwendig. Eine kasuistische Betrachtung wird den allgemeinen Überlegungen zu diesem Problem angeschlossen.
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Sapkas, G., O'Brien, J.P. Vascular compression of the duodenum (cast syndrome) associated with the treatment of spinal deformities. Arch. Orth. Traum. Surg. 98, 7–11 (1981). https://doi.org/10.1007/BF00389703
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DOI: https://doi.org/10.1007/BF00389703