RESUMO
It is presented the cases of a patient suffering from a rare surgical condition, Wilkie's syndrome, duodenal compression syndrome through aorto-mesenteric clamp, also known as the superior mesenteric artery syndrome (SMAS). The authors wish to underline the diagnosis difficulties which concurred to a delay of surgical cure, also presenting the surgical technique methods used for solving this case. Among the large number of operations till now proposed for the management of this syndrome, the chosen solution-resection of the first jejunal loop together with the duodenojejunal junction followed by prevascular lateroterminal duodenojejunal anastomosis--was imposed by the coexistence of an intestinal malrotation, forming the so called "common mesentery".