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.

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

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.

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

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

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.

scholarly journals Retroperitoneal Lipoma Presenting with Nutcracker-Like Phenomenon

2013 ◽  
Vol 2013 ◽  
pp. 1-2 ◽  
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.

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.

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.

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 Nutcracker Syndrome: A Rare Cause of Hematuria

2006 ◽  
Vol 6 ◽  
pp. 745-746 ◽  
Author(s):  
Emmanuel C. Gorospe ◽  
Michael O. Aigbe
Keyword(s):  
Superior Mesenteric Artery ◽  
Renal Vein ◽  
Mesenteric Artery ◽  
Left Renal Vein ◽  
Nutcracker Syndrome ◽  
Renal Veins ◽  
Collecting System

Nutcracker syndrome is the compression of the left renal vein between the aorta and superior mesenteric artery. It is a rare cause of hematuria which results from the rupture of congested renal veins into the collecting system.

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.

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