Superior mesenteric artery syndrome following esophageal cancer surgery: A report of two cases and a literature review

The present study describes two cases of superior mesenteric artery syndrome (SMAS) which occurred following esophageal cancer surgery. The first case was that of a 68-year-old woman who underwent left sided trans-thoracic esophagectomy for esophageal squamous cell carcinoma. Specific symptoms, including bloating and postprandial vomiting, firstly appeared repeatedly 1 week following surgery. She was diagnosed with SMAS using a barium swallow (upper gastrointestinal series), and the symptoms did not improve following nutritional support treatment. Finally, the symptoms were relieved following a duodenojejunostomy. The second case involved a 66-year-old woman who underwent radical esophageal cancer resection. At 4 years after the surgery, the patient developed abdominal distension and postprandial vomiting. She was diagnosed with SMAS, again using an upper gastrointestinal series. Her symptoms were relieved following parenteral nutrition support. SMAS is a rare disease characterized by abdominal distension and vomiting. It is similar to the gastrointestinal manifestations caused by anastomotic stenosis and gastrointestinal reconstruction following esophageal cancer surgery, and it may also prompt thoracic surgeons to ignore the diagnosis of SMAS. Therefore, the possibility of SMAS occurrence in patients who have undergone radical esophageal cancer surgery, should be taken into consideration if they experience gastrointestinal symptoms, including abdominal distension and vomiting, following a rapid weight loss.