Introduction: Superior mesenteric artery (SMA) syndrome is a rare clinical entity characterized by compression of the third portion of the duodenum between the aorta and the SMA resulting in acute or chronic duodenal obstruction. Surgery, most commonly a duodeno-jejunostomy, is employed for patients failing medical therapy.

Methods: The pathophysiology, diagnosis, and treatment strategies for SMA syndrome are reviewed. Post site positioning and operative techniques of a laparoscopic duodeno-jejunal bypass are demonstrated.

Results: A 21 year old female with symptoms of proximal intestinal obstruction and confirmation of SMA syndrome on CT, UGI, and EGD underwent laparoscopic duodeno-jejunostomy. With 2 months follow-up the patient's symptoms have completely resolved.

Conclusion: Laparoscopic duodeno-jejunostomy is a feasible and safe method for treatment of SMA syndrome.