scholarly journals Spontaneous rupture of the ovarian vein in association with nutcracker syndrome: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Akihito Yamamoto ◽  
Seiryu Kamoi ◽  
Shunji Suzuki
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Renal Vein ◽  
Spontaneous Rupture ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Vascular Network ◽  
Retroperitoneal Hematoma ◽  
Nutcracker Syndrome ◽  
Ovarian Vein

Abstract Background Nutcracker syndrome is a condition in which the left renal vein is pinched between the abdominal aorta and the superior mesenteric artery, resulting in an increase in renal vein pressure and certain symptoms. We report a very rare case of retroperitoneal hematoma caused by the rupture of varicose veins of the left ovary. Case presentation A 77-year-old Japanese woman, para 7, experienced sudden left lower abdominal pain. She had no history of trauma or treatment complications. Computed tomography revealed a left retroperitoneal hematoma, but her abdominal pain subsided quickly; thus, urgent treatment was not required. We then scheduled her for an assessment regarding the cause of her bleeding. However, 6 days after the pain onset, abdominal pain symptoms recurred, confirming hematoma regrowth. Magnetic resonance imaging and three-dimensional computed tomography revealed an abnormal vascular network from the left side of the uterus to the left adnexa. Subsequent angiography revealed that the retroperitoneal bleeding originated from rupture of the distended left ovarian vein, which caused blood reflux from the left renal vein to the left ovarian vein. Although angiography confirmed a passage between the left renal vein and inferior vena cava, computed tomography showed obvious stenosis in the left renal vein. In accordance with these findings, we diagnosed the cause of the distention and rupture of the left ovarian vein as nutcracker syndrome. She underwent embolization of the left ovarian vein as hemostasis treatment, and had a good course thereafter. Conclusions This is the first report of a spontaneous rupture of the left ovarian vein caused by nutcracker syndrome. Nutcracker syndrome is not yet well known to clinicians and should be considered as part of the differential diagnosis when an abnormal vascular network in the pelvis is found.

Nutcracker Syndrome: Case Report on the Management of Recurrent Stenosis After Stenting

2017 ◽  
Vol 51 (4) ◽  
pp. 203-208 ◽  
Author(s):  
Natasha Hansraj ◽  
Abdul Hamdi ◽  
Ali Khalifeh ◽  
Eric Wise ◽  
Rajabrata Sarkar ◽  
...  
Keyword(s):  
Renal Vein ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Stent Migration ◽  
Venous Hypertension ◽  
Intractable Pain ◽  
Nutcracker Syndrome ◽  
Extrinsic Compression ◽  
Vein Bypass ◽  
Renal Venous Hypertension

Nutcracker syndrome is a clinical entity leading to renal venous hypertension due to extrinsic compression of the left renal vein by the superior mesenteric artery. Current surgical therapy involves placement of an oversized renal vein stent with partial protrusion into the inferior vena cava (IVC) to relieve stenosis and prevent stent migration. Here, we present a patient with intractable pain and hematuria secondary to nutcracker syndrome who underwent left renal vein stent placement and developed recurrent symptoms due to flow-limiting kinking at the left renal hilum, with partial obstruction of the IVC from pseudointimal hyperplasia. This was treated with stent excision and construction of a left neorenal vein bypass. Thus, given these complications, we should perhaps revisit the recommendations for oversizing of the stent.

scholarly journals Nutcracker Syndrome Complicated by Left Renal Vein Thrombosis

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Faouzi Mallat ◽  
Wissem Hmida ◽  
Mehdi Jaidane ◽  
Nadia Mama ◽  
Faouzi Mosbah
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Renal Vein ◽  
Left Renal Vein ◽  
Renal Vein Thrombosis ◽  
Flank Pain ◽  
Complete Disappearance ◽  
Nutcracker Syndrome ◽  
Rare Entity ◽  
Vein Thrombosis

Isolated renal vein thrombosis is a rare entity. We present a patient whose complaint of flank pain led to the diagnosis of a renal vein thrombosis. In this case, abdominal computed tomography angiography was helpful in diagnosing the nutcracker syndrome complicated by the renal vein thrombosis. Anticoagulation was started and three weeks later, CTA showed complete disappearance of the renal vein thrombosis. To treat the Nutcracker syndrome, we proposed left renal vein transposition that the patient consented to.

scholarly journals Evaluation of left renal vein and inferior vena cava variations through routine abdominal multi-slice computed tomography

2014 ◽  
Vol 73 (2) ◽  
pp. 159-163 ◽  
Author(s):  
N. Boyaci ◽  
E. Karakas ◽  
D. S. Dokumacı ◽  
S. Yildiz ◽  
H. Cece
Keyword(s):  
Computed Tomography ◽  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava

scholarly journals Inverted Nutcracker Syndrome: A Case of Persistent Hematuria and Pain in the Presence of a Left-Sided Inferior Vena Cava

2011 ◽  
Vol 11 ◽  
pp. 1031-1035 ◽  
Author(s):  
Obi Ekwenna ◽  
Michael A. Gorin ◽  
Miguel Castellan ◽  
Victor Casillas ◽  
Gaetano Ciancio
Keyword(s):  
Inferior Vena Cava ◽  
Superior Mesenteric Artery ◽  
Renal Vein ◽  
Mesenteric Artery ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Left Kidney ◽  
Vena Cava ◽  
Nutcracker Syndrome ◽  
The Right

Nutcracker syndrome is described as the symptomatic compression of left renal vein between the aorta and the superior mesenteric artery, resulting in outflow congestion of the left kidney. We present the case of a 51-year-old male with a left-sided inferior vena cava, resulting in compression of the right renal vein by the superior mesenteric artery. Secondary to this anatomic anomaly, the patient experienced a many-year history of flank pain and intermittent gross hematuria. We have termed this unusual anatomic finding and its associated symptoms as the “inverted nutcracker syndrome”, and describe its successful management with nephrectomy and autotransplantation.

scholarly journals Aortomegaly Causing Nutcracker Syndrome and Pelvic Congestion Syndrome

2018 ◽  
Vol 02 (03) ◽  
pp. 197-200
Author(s):  
Krantikumar Rathod ◽  
Amit Sahu ◽  
Bhavesh Popat ◽  
Hemant Deshmukh
Keyword(s):  
Renal Function ◽  
Renal Vein ◽  
Left Renal Vein ◽  
Nutcracker Syndrome ◽  
Ovarian Vein ◽  
Endovascular Management ◽  
Management Options ◽  
Pelvic Congestion Syndrome ◽  
Pelvic Varices ◽  
Pelvic Congestion

AbstractThe authors present an uncommon cause of pelvic congestion syndrome (PCS) secondary to anterior nutcracker syndrome, which was caused by aortomegaly. Positional flank and pelvic pain was the only presenting feature with no renal dysfunction. Early and significant decompression of left renal vein (LRV) via left ovarian vein resulted in preserved renal function with symptomatic pelvic varices. Endovascular management by left ovarian vein coiling and LRV stenting was done. They briefly review the etiopathology, imaging, treatment rationale, and management options for nutcracker and PCS.

scholarly journals A Case of the Nutcracker Syndrome Developed after Delivery

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Koji Tsumura ◽  
Kanae Yoshida ◽  
Sachi Yamamoto ◽  
Sayuri Takahashi ◽  
Katsuyuki Iida ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Superior Mesenteric Artery ◽  
Renal Vein ◽  
Mesenteric Artery ◽  
Left Renal Vein ◽  
Ureteral Orifice ◽  
Nutcracker Syndrome ◽  
Gross Hematuria ◽  
First Report ◽  
Enhanced Computed Tomography

We report a case of nutcracker syndrome that developed after delivery. A 32-year-old woman visited our clinic complaining of gross hematuria 4 months after delivery. Urethrocystoscopic examination failed to show hematuria coming from the ureteral orifice; however, enhanced computed tomography revealed the compression of the left renal vein between the aorta and superior mesenteric artery. Therefore, we diagnosed her with nutcracker syndrome and conservatively observed her. The macrohematuria disappeared by itself after 1 month. This is the first report to describe a case of nutcracker syndrome that developed after delivery.

scholarly journals Huge Trombus including Left Renal Vein, Ovarian Vein, and Inferior Vena Cava Mimicking Renal Colic

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Sakir Ongun ◽  
Sermin Coban ◽  
Abdullah Katgi ◽  
Funda Obuz ◽  
Aykut Kefi
Keyword(s):  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Left Kidney ◽  
Vena Cava ◽  
Ovarian Vein ◽  
Myeloproliferative Disease ◽  
Contrast Enhanced ◽  
Chronic Myeloproliferative Disease

A 31-year-old female presented with acute left flank pain; she had a C/S at the postpartum day 24. Ureteral stone was suspected but ultrasound examination was normal. Then Doppler ultrasound revealed a trombus in left renal vein and inferior vena cava. Contrast enhanced MDCT scan showed swelled and nonfunctional left kidney, a trombus including distal part of left ovarian vein, left renal vein, and inferior vena cava. We started anticoagulation treatment. Further examination revealed diagnosis of chronic myeloproliferative disease. The trombus was completely recanalized at 3-month followup.

Evaluation of the left renal vein variations and inferior vena cava variations by means of helical computed tomography

2013 ◽  
Vol 37 (3) ◽  
pp. 530-535 ◽  
Author(s):  
Alper Dilli ◽  
Umit Yasar Ayaz ◽  
Hatice Kaplanoğlu ◽  
Hakan Saltas ◽  
Baki Hekimoglu
Keyword(s):  
Computed Tomography ◽  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Helical Computed Tomography

scholarly journals Nonrotation of gut with nutcracker syndrome: a rare presentation

2021 ◽  
Vol 8 (9) ◽  
pp. 2819
Author(s):  
Saket Jha ◽  
Shahaji Deshmukh ◽  
Apoorva Kulkarni ◽  
Abhaya Gupta ◽  
Paras Kothari
Keyword(s):  
Abdominal Pain ◽  
Renal Vein ◽  
Mesenteric Artery ◽  
Left Renal Vein ◽  
Nutcracker Syndrome ◽  
Simultaneous Presence ◽  
Rare Presentation ◽  
Rare Diagnosis ◽  
Ladd’S Procedure

Nutcracker syndrome is a rare diagnosis which presents with hematuria, abdominal pain and is caused by left renal vein entrapment in between abdominal aorta and superior mesenteric artery. Symptomatic presentation of rotational abnormalities of gut are rare in adults though it can present with abdominal pain. Simultaneous presence of nonrotation with nutcracker syndrome was very rarely reported in literature. The authors reported a 38 year old female who presented with chronic pain in left side of abdomen and was diagnosed as nutcracker syndrome with nonrotation of gut. Patient underwent Ladd’s procedure with left renal vein transposition. Patient was asymptomatic on follow up. Search of literature showed only two previous cases being reported making it a very rare presentation.

scholarly journals Nutcracker Syndrome Masquerading as Renal Colic in an Adolescent Athlete: A Case Report

2021 ◽  
Vol 5 (4) ◽  
pp. 415-418
Author(s):  
Ron Waldrop ◽  
Paul Henning
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Superior Mesenteric Artery ◽  
Renal Vein ◽  
Mesenteric Artery ◽  
Renal Colic ◽  
Left Renal Vein ◽  
Flank Pain ◽  
Distance Runner ◽  
Nutcracker Syndrome

Introduction: Abdominal pain and flank pain cause a significant proportion of emergency department (ED) visits. The diagnosis often remains unclear and is frequently associated with repeat visits to the ED for the same complaint. A rare cause of left upper abdominal and flank pain is compression of the left renal vein between the aorta and the superior mesenteric artery known as nutcracker syndrome. Diagnostic findings on ultrasound include increased left renal vein diameter proximal and peak blood flow velocity increase distal to the superior mesenteric artery. We describe such a patient presenting to an ED repeatedly with severe pain mimicking renal colic before the final diagnosis and intervention occurred. Case Report: A 16-year-old female, long-distance runner presented four times complaining of intractable left upper quadrant abdominal pain radiating to the left flank after exercise. On each visit urinalysis revealed proteinuria and hematuria, and on two visits abdominal computed tomography revealed no kidney stone or dilatation of the collecting system. Ultimately, she was referred to vascular surgery where Doppler ultrasonography was used to diagnose left renal vein compression. Transposition of the left renal vein improved Doppler diameter and flow measurements and eliminated symptoms. Conclusion: Emergency physicians must maintain a large list of possible diagnoses during the evaluation of abdominal and flank pain with a repetitive and uncertain etiology. Nutcracker syndrome may mimic other causes of abdominal and flank pain such as renal colic and requires appropriate referral.

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