• Mark A A Crowther, Peter J Webb, and Ian A Eyre-Brook.
• Departments of Orthopaedics and General Surgery, Musgrove Park Hospital, Taunton, Somerset, United Kingdom. maacrowther@hotmail.com
• Spine. 2002 Dec 15;27(24):E528-33.

Study DesignA retrospective report of three cases outlining upper intestinal obstruction as a rare complication following surgery for scoliosis.ObjectiveTo present the clinical features, progression, and management of duodenal obstruction due to superior mesenteric artery compression after surgical treatment of scoliosis.Summary Of Background DataSuperior mesenteric artery or cast syndrome has been reported historically in the literature. Many causes are described, among which is the complication of the surgical and nonoperative treatment of scoliosis.MethodsThree adolescent patients were investigated for nausea and vomiting following surgical correction of scoliosis.ResultsContrast radiography confirmed extrinsic obstruction of the third part of the duodenum by the superior mesenteric artery in all three patients. They were jointly managed with the gastrointestinal surgeons. Two patients recovered with conservative treatments, but the third required operative intervention with a laparotomy.ConclusionsVomiting following surgery for scoliosis should be investigated thoroughly, as superior mesenteric artery syndrome carries significant morbidity, protracted hospital stay, and potential mortality.

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