Superior Mesenteric Artery Syndrome Following Bariatric Surgery: A Systematic Review.

Superior mesenteric artery (SMA) syndrome is a rare cause of upper gastrointestinal obstruction caused by compression of the third part of the duodenum following loss of the mesenteric fat pad. This systematic review evaluated the frequency, diagnosis, management, and outcomes of SMA syndrome after Metabolic & Bariatric Surgery (MBS). A PRISMA-guided & PROSPERO registered search identified 11 studies reporting 20 cases, all in female patients, most commonly following Roux-en-Y gastric bypass. Diagnosis was confirmed with CT scan in most cases. Conservative management was successful in 15%, while 85% required surgical intervention, most frequently duodenojejunostomy. Overall symptom resolution occurred in 95%. In conclusion, SMA syndrome, although very rare, should be considered in MBS patients with refractory obstructive symptoms, with surgical management often required for definitive resolution.