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- W2584897951 abstract "Setting: Pediatric rehabilitation unit. Patient: A 12-year-old girl with spastic diplegic cerebral palsy and neuromuscular scoliosis. Case Description: She underwent anterior spinal fusion surgery for correction of severe scoliosis. In the early postoperative period, she had new-onset worsened paraparesis and difficulty with feeding. She was transferred to the rehabilitation unit with the goal of reestablishing preoperative muscle strength and functional ability. She had an upper-lumbar American Spinal Injury Association grade C spinal cord injury (SCI), (exact level uncertain due to preexisting spastic diplegia and mental retardation), was vomiting with feeding, and had lost 3.6kg body weight since surgery. Over 7 days in rehabilitation, she lost an additional 6.6kg and had decreased appetite, unformed stools, and bilious vomiting. Plain abdominal film revealed nonspecific gaseous distention of bowel. Barium upper gastrointestinal series demonstrated abrupt linear cutoff of barium flow at the third duodenal segment suggestive of superior mesenteric artery (SMA) syndrome. Assessment/Results: She was transferred to the pediatric medical ward and started on hypercaloric total parenteral nutrition to promote weight gain. As she regained weight, signs and symptoms of duodenal obstruction improved, eventually enabling the patient to participate with therapies and improve in functional activities. She was discharged home. She died 2 months later from bowel obstruction and perforation. Discussion: SMA syndrome is a rare but serious cause of obstruction of the duodenum in the acute aortomesenteric angle formed by the SMA anteriorly and the aorta posteriorly. Predisposing factors include rapid weight loss, SCI (especially if associated with tetraplegia), and spinal surgery, among others. Conclusions: Bowel obstruction due to SMA syndrome may occur in patients with rapid weight loss, SCI, or recent spinal surgery and can be life threatening. Early recognition, intervention, and very close follow-up are critical in preventing excess morbidity and mortality in this condition." @default.
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- W2584897951 date "2005-09-01" @default.
- W2584897951 modified "2023-10-18" @default.
- W2584897951 title "Poster 149" @default.
- W2584897951 doi "https://doi.org/10.1016/j.apmr.2005.07.174" @default.
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