Case ReportInternational Journal of Research in Medical Sciences

Publication:
Wilkie syndrome as a cause of upper intestinal obstruction and its minimally invasive surgical management: a case report and review of the literature

Int J Res Med Sci. 2025;13(5):2154-2158.DOI10.18203/2320-6012.ijrms20251035

Thumbnail Image

Files

ijrms-15092.pdf (627.19 KB)
View on the journal's website

Abstract

Upper bowel obstruction is a diagnostic and therapeutic challenge due to the proximity of vascular structures and the anatomical constraints imposed by the thorax. Wilkie syndrome, a rare cause of upper GI obstruction, is associated with severe aortomesenteric compression and is usually diagnosed in children and adolescents. We present the case of an 18-year-old male patient with postprandial fullness, recurrent vomiting and epigastric pain. Contrast tomography showed severe gastric dilatation, a reduced aortomesenteric angle (11°) and an aortomesenteric distance of 3 mm, confirming the diagnosis. Endoscopy showed signs of gastric ischaemia with suspected perforation. Emergency diagnostic laparoscopy was performed and gastric perforation with mediastinal communication and duodenal ischaemia was identified. A partial gastrectomy with latero-lateral duodeno-jejunal anastomosis was performed. The postoperative course was favourable with tolerance to diet on day 3 and no complications at 3 months follow-up. Laparoscopic surgery represents a safe and effective alternative in the management of Wilkie's syndrome, reducing morbidity and optimising postoperative recovery.

Keywords

Affiliations

  1. Department of Surgery, Hospital Regional “Elvia Carrillo Puerto”, ISSSTE, Yucatán, Mexico, Facultad de Medicina de la Universidad Autónoma de Yucatán; Department of Medicine, Universidad Autónoma de Yucatán, Yucatán, México
  2. Department of Surgery, Hospital Regional “Elvia Carrillo Puerto”, ISSSTE, Yucatán, México
  3. Department of Surgery, Hospital Regional “Elvia Carrillo Puerto”, ISSSTE, Yucatán, Mexico, Facultad de Medicina de la Universidad Autónoma de Yucatán; Department of Coloproctology, Hospital General de México, Mexico City, México
  4. Department of Surgery, Hospital Regional “Elvia Carrillo Puerto”, ISSSTE, Yucatán, Mexico, Facultad de Medicina de la Universidad Autónoma de Yucatán; Department of Medicine, Universidad Autónoma de Yucatán, Yucatán, México; Department of Gastrointestinal Endoscopy, Hospital Regional de Alta Especialidad del Bicentenario, ISSSTE, Tultitlán, México
  5. Department of Surgery, Hospital Regional “Elvia Carrillo Puerto”, ISSSTE, Yucatán, Mexico, Facultad de Medicina de la Universidad Autónoma de Yucatán
  6. Department of Surgery, Hospital Regional “Elvia Carrillo Puerto”, ISSSTE, Yucatán, Mexico, Facultad de Medicina de la Universidad Autónoma de Yucatán; Department of Research and Education Division, Medical Care and Research, Yucatán, México; Genomic-Metabolic Unit, Universidad Marista de Mérida, Yucatán, México
  7. Genomic-Metabolic Unit, Universidad Marista de Mérida, Yucatán, México
  8. Department of Surgery, Clínica Hospital Mérida-ISSSTE, Yucatán, Mexico, Facultad de Medicina de la Universidad Autónoma de Yucatán, México

Full item record