Asymptomatic nutcracker phenomenon: entrapment of the left renal vein shown by CT without left flank or pelvic pain, or macroscopic haematuria

The nutcracker syndrome is a rare syndrome in which the left renal vein is compressed between the aorta and the superior mesenteric artery or even more rarely between the aorta and vertebral body, in case of an anatomical variation of the left renal vein. It is more likely discovered within young patients presenting pelvic pain, hematuria, or varicocele. Treatments vary from conservative, to surgical or endovascular. Here we present the case of a young patient with chronic pelvic pain and hematuria, diagnosed as a posterior nutcracker syndrome.

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

Journal of Biomedical Graphics and Computing ◽

10.5430/jbgc.v7n1p13 ◽

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.

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Retroperitoneal Lipoma Presenting with Nutcracker-Like Phenomenon

Case Reports in Urology ◽

10.1155/2013/893242 ◽

2013 ◽

Vol 2013 ◽

pp. 1-2 ◽

Cited By ~ 1

Author(s):

Seiichi Saito

Keyword(s):

Computed Tomography ◽

Renal Artery ◽

Renal Vein ◽

Left Renal Vein ◽

Flank Pain ◽

Left Renal Artery ◽

Left Flank ◽

Left Flank Pain

Retroperitoneal lipoma presenting with a nutcracker-like phenomenon is extremely rare. I experienced a case of a 65-year-old man presenting with left flank pain and macrohematuria intermittently for 3 years. Computed tomography revealed a lipoma at the left pedicle of the kidney, 30 mm in diameter, causing a curving of the left renal artery and dilatation of the left renal vein. This patient was treated successfully by retroperitoneoscopic resection of the lipoma. There have been no symptoms for 10 years after the operation.

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Anterior Nutcracker Syndrome with Left Gonadal Vein Varicosities on Multiphasic Computed Tomography: An Unexpected Cause of Pyeloureteral Junction Obstruction

Urologia Internationalis ◽

10.1159/000381270 ◽

2015 ◽

Vol 97 (4) ◽

pp. 482-484

Author(s):

Maddalena Di Carlo ◽

Caterina Gaudiano ◽

Fiorenza Busato ◽

Simone Pucci ◽

Riccardo Schiavina ◽

...

Keyword(s):

Superior Mesenteric Artery ◽

Renal Vein ◽

Mesenteric Artery ◽

Left Renal Vein ◽

Nutcracker Syndrome ◽

Left Flank ◽

Gonadal Vein ◽

Renal Hilum ◽

Left Flank Pain ◽

Uncommon Complication

The anterior nutcracker syndrome is defined by the compression of the left renal vein between the aorta and superior mesenteric artery, usually related to the occurrence of hematuria. We report the case of an uncommon complication of the nutcracker syndrome. A 75-year-old woman was referred to our institution for left flank pain without hematuria. Multiphasic computer tomography urography showed a condition of left renal vein entrapment between the aorta and superior mesenteric artery with the development of left gonadal vein varicosities at the level of the renal hilum; a pyeloureteral junction compression with dilation of the pyelocalyceal system coexisted. To our knowledge, this is the first report of the association between nutcracker syndrome and pyeloureteral junction obstruction.

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Vanishing splenic cyst- visible on ultrasound but non-detected on MRI

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld-208 ◽

2019 ◽

Vol 28 (3) ◽

pp. 262-262

Author(s):

Cosmin Caraiani ◽

Timothy Kurniawan ◽

Renata Vasilache ◽

Ciprian Brisc

Keyword(s):

Gastric Emptying ◽

Renal Vein ◽

Mesenteric Artery ◽

Delayed Gastric Emptying ◽

Left Renal Vein ◽

Flank Pain ◽

Splenic Cyst ◽

Compression Syndrome ◽

Left Flank ◽

Left Flank Pain

This paper ilustrates the imaging aspect of a rare pathology- aorto-mesenteric compression syndrome (Wilkie's disease). In this disease acute angulation of the superior mesenteric artery will lead to compression of the duodenum and of the left renal vein. Duodenal compression may lead to delayed gastric emptying and to nutcraker syndrome when left flank pain and hematuria may be present

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