Nutcracker Syndrome and Radiographic Evaluation of Loin Pain and Hematuria

Bhanji, Amir; Malcolm, Paul; Karim, Mahzuz

doi:10.1053/j.ajkd.2009.10.010

Cited by 14 publications

(8 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Anterior nutcracker syndrome refers to compression of the LRV as described above. However, another variant, posterior nutcracker syndrome (figure 4) has also been described and refers to the retroaortic position of the LRV with compression of the vessel between the aorta and the vertebral column 1 2…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

An easily missed diagnosis: flank pain and nutcracker syndrome

2013

View full text Add to dashboard Cite

A 27-year-old woman presented to her primary care doctor's office with left flank pain. CT of the abdomen showed an isolated left renal vein thrombus. The clot was initially attributed to her oral contraceptive use; however, closer inspection of CT images revealed nutcracker phenomenon (compression of the renal vein between the superior mesenteric artery and abdominal aorta). Intravascular ultrasound imaging confirmed the diagnosis. Nutcracker syndrome is a rare condition, which if left untreated may cause damage to the left kidney. Although under diagnosed, there are several treatment options available ranging from simple surveillance to surgical resolution.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Studies note bimodal peak with most cases identified in adolescence to young adulthood and then again in the third to fourth decades of life with a slightly higher prevalence in women 2 3…”

Section: Discussionmentioning

confidence: 99%

An easily missed diagnosis: flank pain and nutcracker syndrome

2013

View full text Add to dashboard Cite

show abstract

“…CTA and MRA provide visualization of the anatomy. These tests can demonstrate the precise LRV compression point and/or prestenotic dilatation of the LRV together with perirenal and/or gonadal vein varices [24] . "Beak sign" is the abrupt narrowing of the LRV with a triangular shape at the aortomesenteric portion.…”

Section: Diagnosismentioning

confidence: 99%

Nutcracker syndrome

Gulleroglu

Gülleroğlu

Baskın

2014

WJN

130

163

View full text Add to dashboard Cite

The nutcracker phenomenon [left renal vein (LRV) entrapment syndrome] refers to compression of the LRV most commonly between abdominal aorta and superior mesenteric artery. Term of nutcracker syndrome (NCS) is used for patients with clinical symptoms associated with nutcracker anatomy. LRV entrapment divided into 2 types: anterior and posterior. Posterior and right-sided NCSs are rare conditions. The symptoms vary from asymptomatic hematuria to severe pelvic congestion. Symptoms include hematuria, orthostatic proteinuria, flank pain, abdominal pain, varicocele, dyspareunia, dysmenorrhea, fatigue and orthostatic intolerance. Existence of the clinical features constitutes a basis for the diagnosis. Several imaging methods such as Doppler ultrasonography, computed tomography angiography, magnetic resonance angiography and retrograde venography are used to diagnose NCS. The management of NCS depends upon the clinical presentation and the severity of the LRV hypertension. The treatment options are ranged from surveillance to nephrectomy. Treatment decision should be based on the severity of symptoms and their expected reversibility with regard to patient's age and the stage of the syndrome.

show abstract

“…Literature data suggests that NCS is slightly more prevalent in women [ 7 ], although other studies indicate no difference in gender [ 3 ]. It is usually diagnosed in the second and third decades of life and tends to be diagnosed earlier in men [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

What Each Clinical Anatomist Has to Know about Left Renal Vein Entrapment Syndrome (Nutcracker Syndrome): A Review of the Most Important Findings

Orczyk

Wysiadecki

Majos

et al. 2017

BioMed Research International

View full text Add to dashboard Cite

Nutcracker syndrome (NCS) is the most common term for compression of the left renal vein between the superior mesenteric artery and the abdominal aorta. The development of NCS is associated with the formation of the left renal vein (LRV) from the aortic collar during the sixth to eighth week of gestation and abnormal angulation of the superior mesenteric artery from the aorta. Collateralization of venous circulation is the most significant effect of NCS. It includes mainly the left gonadal vein and the communicating lumbar vein. Undiagnosed NCS may affect retroperitoneal surgery and other radiological and vascular procedures. The clinical symptoms of NCS may generally be described as renal presentation when symptoms like haematuria, left flank pain, and proteinuria occur, but urologic presentation is also possible. Radiological methods of confirming NCS include Doppler ultrasonography as a primary test, retrograde venography, which can measure the renocaval pressure gradient, computed tomography angiography, which is faster and less traumatic, intravascular ultrasound, and magnetic resonance angiography. Treatment can be conservative or surgical, depending on the severity of symptoms and degree of LRV occlusion. Nutcracker syndrome is worth considering especially in differential diagnosis of haematuria of unknown origin.

show abstract

Nutcracker Syndrome and Radiographic Evaluation of Loin Pain and Hematuria

Cited by 14 publications

References 15 publications

An easily missed diagnosis: flank pain and nutcracker syndrome

An easily missed diagnosis: flank pain and nutcracker syndrome

Nutcracker syndrome

What Each Clinical Anatomist Has to Know about Left Renal Vein Entrapment Syndrome (Nutcracker Syndrome): A Review of the Most Important Findings

Contact Info

Product

Resources

About