Actitud expectante en el síndrome del cascanueces

Abstract

Nutcracker syndrome is caused by compression of the left renal vein between the aorta and the superior mesenteric artery where it passes in the fork formed at the bifurcation of these arteries. The phenomenon results in left renal venous hypertension. The syndrome is manifested by left flank and abdominal pain, with or without unilateral haematuria. The nutcracker syndrome has been treated in various ways. We report one case of the syndrome and discuss the place of surveillance in its management.

Nutcracker syndrome: A rare cause of chronic pelvic pain and left back pain

“…This results in dilation of the left renal and gonadal veins with development of collateral venous circulation (Pyelocaliceal, peri-ureteral and gonadal) due to congestion and increased venous pressure. It is a rare and underestimated syndrome, which mainly affects young adults with a vast majority of women [ 5 , 6 ]. Its prevalence remains unknown, probably because it is often misdiagnosed and commonly asymptomatic.…”

Lumbalgia en un caso clínico de "síndrome del cascanueces"

“…En la literatura revisada, los casos clínicos presentan hematuria como síntoma más frecuente y dolor abdominal. En el que presentamos el dolor evoluciona de dolor cólico, visceral, a dolor lumbar nociceptivo, siendo este el síntoma principal y no asociado a hematuria (1,(4)(5)(6)(7).…”

“…Suele producirse en personas jóvenes, previamente sanas, en ambos sexos. La compresión conlleva una hipertensión en la vena renal izquierda, lo cual puede producir una ruptura de su pared en el fórnix del cáliz renal, apareciendo hematuria macroscópica intermitente o microhematuria 1 .…”