Nutcracker syndrome: A rare cause of left flank pain that can also manifest as unexplained pelvic pain

2017 ◽  
Vol 84 (5) ◽  
pp. 557-562 ◽  
Author(s):  
Jean-Marie Berthelot ◽  
Frédéric Douane ◽  
Yves Maugars ◽  
Eric Frampas
Keyword(s):  
Pelvic Pain ◽  
Flank Pain ◽  
Nutcracker Syndrome ◽  
Left Flank ◽  
Left Flank Pain

scholarly journals A rare presentation of nutcracker syndrome and it’s vascular managment

2017 ◽  
Vol 7 (1) ◽  
pp. 13
Author(s):  
Nguessan Judicael Ahoury ◽  
Salami Fatima Adéniké ◽  
Ndja Ange Patrick ◽  
Cavez Nicolas ◽  
Kouassi Paul Nzi
Keyword(s):  
Renal Vein ◽  
Mesenteric Artery ◽  
Left Renal Vein ◽  
Flank Pain ◽  
Nutcracker Syndrome ◽  
Rare Presentation ◽  
Left Flank ◽  
Long Time ◽  
Angio Ct ◽  
Left Flank Pain

Nutcracker syndrome includes all the symptoms associated with the narrowing of the left renal vein (LRV). That narrowing occurs between the aorta and the Superior Mesenteric Artery (anterior) or vertebra (posterior). The symptoms are various and not specific but the patient sometimes presents hematuria with or without left flank pain. We report a case on a 42 years old woman, who was suffering from left flank pain for a long time aggravated during and after each pregnancy. The diagnosis of nutcracker syndrome was initially omitted. Abdominal pelvic Angio CT and venography were performed. We placed a percutaneous stent in the narrowed portion of the renal vein. The result was successful.

Nutcracker Syndrome as an Unusual Cause of Postprandial Pain

2019 ◽  
Vol 54 (3) ◽  
pp. 283-285
Author(s):  
Krystal C. Maloni ◽  
Keith D. Calligaro ◽  
William Lipshutz ◽  
Kunal Vani ◽  
Douglas A. Troutman ◽  
...  
Keyword(s):  
Inferior Vena ◽  
Varicose Veins ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Oral Intake ◽  
Flank Pain ◽  
Nutcracker Syndrome ◽  
Left Flank ◽  
Postprandial State ◽  
Left Flank Pain

Nutcracker syndrome is a rare entity in which compression of the left renal vein (LRV), usually by the overlying superior mesenteric artery (SMA), results in renal venous congestion and reflux in the left ovarian vein (LOV). Patients may present with hematuria, left flank pain, dyspareunia, and vaginal or abdominal wall varicose veins. We report a patient with nutcracker syndrome who presented atypically with left flank pain that was exacerbated in the postprandial state. We hypothesize that the physiologic dilation of the SMA after oral intake caused increased LRV compression at that site and augmented lateral LRV distention. The patient had no evidence of SMA syndrome or chronic mesenteric insufficiency. Her symptoms resolved after we performed an LOV to inferior vena cava transposition.

scholarly journals Nutcracker Syndrome in Children: Role of Doppler Ultrasonographic Indices in Detecting the Pattern of Symptoms

2018 ◽  
Vol 7 (8) ◽  
pp. 214 ◽  
Author(s):  
Hulya Nalcacioglu ◽  
Meltem Ceyhan Bilgici ◽  
Demet Tekcan ◽  
Gurkan Genc ◽  
Yakup Bostanci ◽  
...  
Keyword(s):  
Renal Vein ◽  
Pediatric Patients ◽  
Left Renal Vein ◽  
Flank Pain ◽  
Nutcracker Syndrome ◽  
Macroscopic Hematuria ◽  
Presenting Symptoms ◽  
Left Flank ◽  
The Mean ◽  
Left Flank Pain

The purpose of this study was to evaluate the clinical characteristics of 44 pediatric patients who were diagnosed as having nutcracker syndrome (NCS). We also investigated the left renal vein Doppler ultrasonography (DUS) results, to determine whether or not there was an association between clinical symptoms and DUS findings among these patients. The clinical data from 44 pediatric patients who were diagnosed as having NCS from January 2008 to December 2015 were retrospectively reviewed. We grouped the patients according to the presenting symptoms as symptomatic (loin pain; macroscopic hematuria or both) and non-symptomatic (microscopic hematuria and proteinuria were detected incidentally) and evaluated the left renal vein DUS indices in these two groups separately. Asymptomatic NCS was found in 27 (61.4%) patients; 21 (47.7%) of whom were admitted for the evaluation of proteinuria. The most frequent presenting symptoms were left flank pain (20.5%) and macroscopic hematuria (13.6%); and 2 (4.5%) patients presented with a combination of left flank pain and macroscopic hematuria. The mean ratio of the diameter of the hilar portion of the left renal vein (LRV) to that of the aortomesenteric portion was 4.36 ± 1.55. The mean ratio of the peak velocity (PV) between the two sites of the LRV was 7.32 ± 2.68 (3.1–15.6). The differences in the ratio of the diameters were statistically significant between the two groups and significantly higher in children with asymptomatic NCS (p = 0.025). The PV ratios of the LRV (p = 0.035) were significantly higher in asymptomatic children with NCS than in the symptomatic group. Our study identifies that increased compression ratio of the LRV entrapment is most observed in orthostatic proteinuria and microscopic hematuria.

Impacted vesicouretric stone a quagmire settled with holmium laser

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Manjeet Kumar ◽  
◽  
Sanjeev Chauhan ◽  
Keyword(s):  
Medical Treatment ◽  
Ct Scan ◽  
Flank Pain ◽  
Nausea And Vomiting ◽  
Holmium Laser ◽  
Operation Theatre ◽  
Left Flank ◽  
Noncontrast Ct ◽  
Left Flank Pain

A 38 years female presented with left flank pain, nausea, and vomiting. Ultrasound and Noncontrast CT scan were suggestive of left hydronephrosis with left Vesicoureteral stone (Figure 1). Conservative medical treatment previously was not successful. Blood investigations were Hb 11.5 gm%, TLC 11500/mm3 , urea 22, creatinine 0.6, urine was full of RBCs. She was taken to the operation theatre for emergency double j stenting. Cystoscopy showed impacted left vesicoureteral stone (Figure 2,3).

scholarly journals Elderly woman with left flank pain

2019 ◽  
Vol 16 ◽  
pp. 100533
Author(s):  
Caroline Trippel ◽  
Anthony Furiato
Keyword(s):  
Elderly Woman ◽  
Flank Pain ◽  
Left Flank ◽  
Left Flank Pain

scholarly journals Left Flank Pain

2015 ◽  
Vol 16 (2) ◽  
pp. 314-315
Author(s):  
Thomas Nappe ◽  
Shawn Quinn
Keyword(s):  
Flank Pain ◽  
Left Flank ◽  
Left Flank Pain

scholarly journals Multiple Renal Abscesses due to ESBL Extended-Spectrum Beta-Lactamase-Producing Escherichia coli Causing Acute Pyelonephritis and Bacteremia: A Case Report with a Good Outcome (No Drainage Required)

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Abdalla Khalil ◽  
Musaad Qurash ◽  
Asem Saleh ◽  
Rasha Ali ◽  
Mohamed Elwakil
Keyword(s):  
Ct Scan ◽  
Acute Pyelonephritis ◽  
Urine Culture ◽  
Flank Pain ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Left Flank ◽  
Extended Spectrum ◽  
Abdomen Ct ◽  
Left Flank Pain

Extended-spectrum beta-lactamase-producing Enterobacteriaceae urinary tract infections are challenging infections with increased mortality, morbidity, and failure of therapy. A 44-year-old Saudi male diabetic patient was seen at the ER of IMC Hospital with features of acute pyelonephritis: fever, burning urine, and left flank pain for three days. He was treated for cystitis at the Endocrine Clinic two weeks prior to his ER visit with nitrofurantoin and levofloxacin orally according to urine culture and sensitivity result. The patient was admitted, received IV meropenem, and continued to be febrile for three days. His urine and blood culture at ER grew the same ESBL-producing E. coli as in his urine culture from the Endocrine Clinic. His abdomen CT scan showed two left renal abscesses at the upper and middle poles. His temperature resolved on the fourth day of IV therapy. Intravenous meropenem was continued for 4 weeks after inserting PICC line and the patient was followed up by home healthcare. He was feeling better with occasional left flank pain and repeated abdomen CT scan showed complete resolution of both renal abscesses.

scholarly journals Left flank pain during pregnancy with an unpredictable etiology: think of nonhemorrhagic adrenal infarction

2021 ◽  
pp. FSO718
Author(s):  
Myriam Jerbaka ◽  
Tracy Slaiby ◽  
Zahraa Farhat ◽  
Yara Diab ◽  
Nawal Toufayli ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Pregnant Woman ◽  
Pregnant Patient ◽  
Flank Pain ◽  
Computed Tomography Scan ◽  
Left Flank ◽  
Left Flank Pain ◽  
Tomography Scan ◽  
Adrenal Infarction

Abdominal pain is the most presenting complaint during pregnancy with multiple etiologies. The diagnosis could be unpredictable. We present a case of 36-year-old pregnant woman gravida 10 para 7 abortus 2 at 36 + 5 weeks of gestation presenting twice for an increasing left abdominal pain, not relieved despite analgesics. She was delivered for severe oligohydramnios. After delivery, she was found to have a left adrenal infarction on computed tomography scan. She was found to have two mutations of the gene  MTHFR 677CC. Our presented case should remind physicians to consider the presence of thromboembolic state during pregnancy. The diagnosis of adrenal infarction should be among the differentials of an ambiguous flank pain that is resilient to medical therapy. Diagnosis in a pregnant patient can be easily confirmed with MRI, after which anticoagulation should be started and the workup for hypercoagulable state investigated.

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