Superior mesenteric artery syndrome

[size=20px]A 15-year-old girl recently lost more than 15% of her body weight due to nausea and emesis associated with symptomatic cholelithiasis which was treated with laparoscopic cholecystectomy. Postoperatively her nausea and emesis persisted and an UGI showed evidence of SMA syndrome with failure of contrast to progress beyond the third portion of the duodenum due to extrinsic compression and a dilated proximal duodenum. She has gained her weight back with non-operative management but continues to have persistent nausea and vomiting. A repeat UGI shows continued delay of contrast across the midline. What is the least invasive appropriate surgical management for this p…

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