Superior Mesenteric Artery Syndrome: Late Complication of Ileal Pouch-Anal Anastomosis

Superior mesenteric artery syndrome (SMAS) is an uncommon condition which difficult to diagnose due non-specificity of symptoms. The most common causes SMAS are severe weight loss secondary medical conditions, surgical history, and cancer. A 31-year-old male with a history ulcerative colitis status-post proctocolectomy ileal pouch-anal anastomosis 10 years prior, presented progressively worsening abdominal pain. Radiographic imaging was consistent SMAS, subsequently confirmed intraoperatively during emergency surgery in Roux-En-Y gastrojejunostomy performed. Clinicians should be aware that rare but possible complication anastomosis. Although rare, there low threshold for this diagnosis when obstructive symptoms present.