scholarly journals From Nutcracker Phenomenon to Nutcracker Syndrome: A Pictorial Review

Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 101
Author(s):  
Antonio Granata ◽  
Giulio Distefano ◽  
Alessio Sturiale ◽  
Michele Figuera ◽  
Pietro Valerio Foti ◽  
...  
Keyword(s):  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Clinical Manifestations ◽  
Nutcracker Syndrome ◽  
Review Of The Literature ◽  
Therapeutic Approaches ◽  
Nutcracker Phenomenon ◽  
Pictorial Review ◽  
Pubmed Database

Left renal vein (LRV) entrapment, also known as nutcracker phenomenon if it is asymptomatic, is characterized by abnormality of outflow from the LRV into the inferior vena cava (IVC) due to extrinsic LRV compression, often accompanied by demonstrable lateral (hilar) dilatation and medial (mesoaortic) stenosis. Nutcracker syndrome, on the other hand, includes a well-defined set of symptoms, and the severity of these clinical manifestations is related to the severity of anatomic and hemodynamic findings. With the aim of providing practical guidance for nephrologists and radiologists, we performed a review of the literature through the PubMed database, and we commented on the definition, the main clinical features, and imaging pattern of this syndrome; we also researched the main therapeutic approaches validated in the literature. Finally, from the electronic database of our institute, we have selected some characteristic cases and we have commented on the imaging pattern of this disease.

scholarly journals Unusual coexistence of double inferior vena cava with nutcracker syndrome–a case report and review of the literature

2020 ◽  
Vol 48 (2) ◽  
pp. 030006052090452
Author(s):  
Anna Waśniewska ◽  
Kacper Ruzik ◽  
Łukasz Olewnik ◽  
Ludomir Stefańczyk ◽  
Michał Polguj
Keyword(s):  
Case Report ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Nutcracker Syndrome ◽  
Review Of The Literature ◽  
Double Inferior 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 Reno-iliac intrasystem anastomoses of the inferior vena cava

2020 ◽  
Vol 21 (2) ◽  
pp. 51-57
Author(s):  
A. A. Kapto
Keyword(s):  
Inferior Vena Cava ◽  
Collateral Circulation ◽  
Inferior Vena ◽  
Varicose Veins ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Nutcracker Syndrome ◽  
Study Objective ◽  
Testicular Vein ◽  
X Ray

The study objective is to describe the anastomoses between the left renal and iliac veins in the inferior vena cava system and to classify these anastomoses.Materials and methods. From 2015 to 2020, 340 men with varicose veins of the pelvic organs and bilateral varicocele were examined. Delayed imaging for 10–30 s with phlebotesticulography of 157 patients allowed us to study in more detail the vascular venous x-ray anatomy of the scrotum and various options for collateral circulation.Results. The data obtained by us during phlebography allowed us to offer our own classification of anastomoses between the left renal vein and the common iliac vein in the inferior vena cava system (reno-iliac intrasystemic anastomoses of the inferior vena cava): 1) through the vein of the vas deferens (v. ductus deferens), 2) through the cremasteric vein (v. cremasterica), 3) through the external testicular vein (v. testicularis externa). In addition to the classification, the terms for specific types of anastomoses are also proposed by us for the first time and do not have a name in the medical scientific literature. A new definition of the term “venous anastomotic node (nodus venarum anastomoticus) of the testis and its appendage” is proposed, which describes the anatomical relationship between the 4 veins: the internal testicular vein, external testicular vein, vena cremasterica and veins of the vas deferens. A new term is proposed “pseudo-varicocele” that defines the compensatory expansion of the internal testicular vein during normal antegrade blood flow through it.Conclusion. In this work, we give an X-ray anatomical description of the development of various types of collateral circulation in the system of the inferior vena cava between the left renal vein and iliac vessels in various types of arteriovenous conflicts of both the upper (nutcracker syndrome, posterior nutcracker syndrome) and the lower level (May–Thurner syndrome).

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.

Retroperitoneal Laparoscopic Reimplantation of the Left Renal Vein for Nutcracker Syndrome

2014 ◽  
Vol 94 (1) ◽  
pp. 74-78 ◽  
Author(s):  
Pengfei Shao ◽  
Pu Li ◽  
Xiaobing Ju ◽  
Chao Qin ◽  
Changjun Yin
Keyword(s):  
Renal Vein ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Operation Time ◽  
Nutcracker Syndrome ◽  
Gross Hematuria ◽  
Short Term ◽  
Total Operation Time ◽  
The Right

Objective: To describe the feasibility of retroperitoneal laparoscopic reimplantation of the left renal vein (LRV) for nutcracker syndrome (NCS). Patients and Methods: Two patients with NCS underwent the surgery. Both patients complained of gross hematuria and flank discomfort that could not be relieved by resting. They were placed in a supine position and 5 ports were placed in the right abdominal wall. The procedures were performed with a retroperitoneal approach. The LRV was transected and then reimplanted into the distal inferior vena cava. Results: The procedures were performed successfully without any major complications. The total operation time was 105 and 120 min, respectively. Hematuria and flank discomfort were resolved after the surgery. Ultrasonography revealed a patent lumen without compression. Conclusions: Retroperitoneal laparoscopic reimplantation of the LRV appears to be a feasible procedure with satisfactory short-term outcomes.

scholarly journals Laparoscopic transposition of the left renal vein into the inferior vena cava for nutcracker syndrome

2010 ◽  
Vol 52 (3) ◽  
pp. 738-741 ◽  
Author(s):  
Olivier Hartung ◽  
Amine Azghari ◽  
Pierre Barthelemy ◽  
Mourad Boufi ◽  
Yves S. Alimi
Keyword(s):  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Nutcracker Syndrome

Intra-abdominal Inferior Vena Cava Injuries: Operative Strategies and Outcomes

2020 ◽  
pp. 000313482097339
Author(s):  
Christine A. Castater ◽  
Margo Carlin ◽  
Virginia D. Parker ◽  
Chris Sciarretta ◽  
Deepika Koganti ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Mortality Rates ◽  
Volume Resuscitation ◽  
Vascular Injuries ◽  
Trauma Centers ◽  
Review Of The Literature ◽  
Hemorrhage Control ◽  
Operative Strategies

Visceral vascular injuries are relatively uncommon even in busy urban trauma centers. The inferior vena cava (IVC) is the most frequently injured visceral vein and can be a complex operative challenge. Despite advances in early volume resuscitation, improved transport times, prompt operative intervention, and hemorrhage control, mortality rates have remained largely unchanged. This article conducts an in-depth review of the literature surrounding IVC injuries and a detailed discussion of operative strategies and management as survivability is ultimately dependent on the grade of injury, location, and the presence of hemorrhagic shock.

Thrombosed interrupted inferior vena cava and retroaortic left renal vein mimicking retroperitoneal neoplasm

2006 ◽  
Vol 32 (3) ◽  
pp. 403-406 ◽  
Author(s):  
Sevdenur Cizginer ◽  
Servet Tatli ◽  
Jeffrey Girshman ◽  
Joshua A. Beckman ◽  
Stuart G. Silverman
Keyword(s):  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Retroperitoneal Neoplasm

Prevalence of Congenital Anomalies of the Inferior Vena Cava: CT Assessment in Thai Patients

2021 ◽  
Vol 104 (9) ◽  
pp. 1459-1464
Keyword(s):  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Renal Veins ◽  
Retrocaval Ureter ◽  
Radiology Reports ◽  
Contrast Enhanced ◽  
Study Population

Objective: To determine the prevalence of inferior vena cava (IVC) anomalies in Thai patients who underwent contrast-enhanced computed tomography (CT) of the abdomen. Materials and Methods: Two radiologists retrospectively and independently reviewed the contrast-enhanced abdominal CT examinations in 1,429 Thai patients between August 1, 2018 and January 25, 2019 who met the inclusion criteria. Patients were included, if (a) their CT showed well visualized IVC, renal veins, and right ureter that were not obliterated by tumor, cyst, fluid collection, or intraperitoneal free fluid, (b) they had not undergone previous abdominal surgery that altered anatomical configuration of the IVC, renal veins, and right ureter. The presence of all IVC anomalies were recorded. Results: Among the 1,429 studied patients, 678 were male (47.4%) and 751 were female (52.6%). The prevalence of IVC anomalies was 3.5%. Five types of IVC anomalies were presented. The most common was circumaortic left renal vein in 24 patients or 48.0% of all IVC anomalies and 1.7% of the study population, followed by retroaortic left renal vein in 15 patients or 30.0 % of all IVC anomalies and 1.0% of the study population. Other IVC anomalies included double IVC, left IVC, and retrocaval ureter at 0.5%, 0.2%, and 0.1% of the study population, respectively. Conclusion: The prevalence of IVC anomalies in the present study differed from the previous studies conducted in other countries, which may be attributable to differences in race and ethnicity. Awareness of these anomalies is essential when evaluating routine CT examinations in asymptomatic patients. Their presence should be carefully noted in radiology reports to avoid anomaly-related complications. Keywords: Prevalence; IVC anomalies; Circumaortic left renal vein; Retroaortic left renal vein; Double IVC; Left IVC; Retrocaval ureter

Repeat hepatectomy with inferior vena cava re-resection for colorectal liver metastases: case report and review of the literature

Surgery Today ◽  
2014 ◽  
Vol 45 (11) ◽  
pp. 1450-1456 ◽  
Author(s):  
Gabriele Marangoni ◽  
Abdul Hakeem ◽  
Atif Khan ◽  
Olorunda Rotimi ◽  
J. Peter Lodge
Keyword(s):  
Case Report ◽  
Inferior Vena Cava ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Inferior Vena ◽  
Vena Cava ◽  
Repeat Hepatectomy ◽  
Review Of The Literature
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