An 89-year-old woman who was bedridden suffered repeated
vomiting due to
superior mesenteric artery syndrome (SMAS). We performed
gastrojejunostomy via the magnetic compression anastomosis (MCA) technique because her situation was not improved by
conservative therapy and because the operative risk was high. We prepared two
neodymium magnets: a flat plate-shaped magnet (15 × 3 mm) and a ring-shaped magnet of the same size. The ring-shaped magnet which passed through a guidewire was pushed to the duodenum by an
endoscope over the guidewire. The duodenal
stricture was balloon-dilated in front of the magnet, and the magnet was pushed all together beyond the
stricture and placed at the duodenojejunal junction. Subsequently, the flat plate-shaped magnet was delivered endoscopically to the stomach using a biopsy
forceps. The magnets were attracted towards each other transmurally after one more flat plate-shaped magnet was added to the gastric-side magnet. Completion of
gastrojejunostomy was confirmed while retrieving the magnets 10 days after starting compression. She has been asymptomatic for 1 month since anastomosis. Endoscopic
gastrojejunostomy using MCA was an effective, low-invasive treatment for SMAS.