2018
DOI: 10.1186/s13256-018-1743-7
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Co-occurring superior mesenteric artery syndrome and nutcracker syndrome requiring Roux-en-Y duodenojejunostomy and left renal vein transposition: a case report and review of the literature

Abstract: BackgroundThe duodenum and the left renal vein occupy the vascular angle made by the superior mesenteric artery and the aorta. When the angle becomes too acute, compression of either structure can occur. Each type of compression is associated with specific clinical symptoms that constitute a rare disorder. If clinical symptoms are mild, conservative treatment is implemented. However, surgery is often the only solution that can improve quality of life and/or avoid life-threatening complications. This report des… Show more

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Cited by 17 publications
(18 citation statements)
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“…1 NCS is a historically more recent clinical phenomenon than SMAS. 4 Given that both the duodenum and the LRV lie within the aortomesenteric angle, two different types of compression syndrome can arise. 4 However, both syndromes occurring concurrently are highly rare.…”
Section: Discussionmentioning
confidence: 99%
See 3 more Smart Citations
“…1 NCS is a historically more recent clinical phenomenon than SMAS. 4 Given that both the duodenum and the LRV lie within the aortomesenteric angle, two different types of compression syndrome can arise. 4 However, both syndromes occurring concurrently are highly rare.…”
Section: Discussionmentioning
confidence: 99%
“…4 Given that both the duodenum and the LRV lie within the aortomesenteric angle, two different types of compression syndrome can arise. 4 However, both syndromes occurring concurrently are highly rare. 3 Generally, there are two main types of NCS, described as anterior and posterior NCS.…”
Section: Discussionmentioning
confidence: 99%
See 2 more Smart Citations
“…An anterior nutcracker syndrome can rarely occur concomitantly with SMA syndrome, in which the SMA compresses the duodenum causing postprandial pain, early satiety, nausea, vomiting, and weight loss. [2][3][4] More commonly, patients with SMA syndrome may also have nutcracker phenomenon where the LRV is compressed but without symptoms. [5][6][7][8] We suspect that physiologic dilation of the SMA after oral intake caused further compression of the LRV and hence a worsening of the patient's left flank pain in the postprandial state.…”
mentioning
confidence: 99%