Scoliosis and acute vascular compression of the duodenum

Operative correction of scoliosis is occasionally associated with acute obstructive vascular compression of the duodenum. Factors contributing to this relationship are: immobilization in bed, the asthenic habitus, body casts, spinal distortion, and weak abdominal muscles. Distention, epigastric pain, and vomiting are the cardinal manifestations. The obstruction is only partial, and bowel sounds are usually normal. Radiologic demonstration of a dilated duodenum is pathognomonic. Initial treatment involves nasogastric suction, position changes and cast removal, if feasible. Should the obstruction persist or recur, it is bypassed by a duodenojejunal side-to-side anastomosis.