We report the case of a 14-year-old boy with pectus excavatum and mild scoliosis. The patient underwent a minimally invasive Nuss repair with excellent cosmetic result. He returned 3 weeks post-operatively with bilious emesis and a 3.6-kg weight loss (5.5% of total body weight). Radiographic evaluation was consistent with the diagnosis of superior mesenteric artery syndrome and the child ultimately required nasojejunal feedings. Following return to his baseline weight, he was transitioned to oral feedings and has done well in follow-up. This is the first report of SMA syndrome following minimally invasive pectus excavatum repair.
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