nutcracker syndrome


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nutcracker syndrome

nonglomerular hematuria due to compression of the left renal vein between the aorta and superior mesenteric artery; renal hilar varices, collateral veins, and proteinuria may be found. See: nutcracker.
A rare clinical complex which occurs in relatively young and previously healthy people, which is characterised by compression of the left renal vein (LRV) between the aorta and superior mesenteric artery (SMA), fancifully likened to the effect of a nutcracker, with the aorta and SMA each corresponding to an arm of the nutcracker and the LRV to the nut itself. The squeezing can lead to left renal vein hypertension, resulting in rupture of the thin walled vein into the renal calyceal fornix
Diagnosis Left renal venography—gold standard test, CT, abdominal ultrasonography
DiffDx Kidney stones, genitourinary malignancy, loin pain haematuria syndrome
Management Nephrectomy, nephropexy, renocaval reimplantation, auto-transplantation, left renal vein transposition, stenting, gonadal vein embolisation

nut·crack·er syn·drome

(nut'krak-ĕr sin-drōm')
Nonglomerular hematuria due to compression of the left renal vein between the aorta and superior mesenteric artery; renal hilar varices, collateral veins, and proteinuria may be found.
References in periodicals archive ?
Because of its rarity and excessive misdiagnosis, we report the case of a 30-year-old female patient who was admitted to emergency department of our hospital with recurrent left flank and lower abdominal pain anddiagnosed with nutcracker syndrome.
Although the terms nutcracker syndrome and nutcracker phenomenon are sometimes used interchangeably in the literature, Shin and Lee (2) have emphasized that the nutcracker anatomy is not always associatedwith clinical symptoms and that some anatomicfindings suggestive of a nutcracker may represent a normalvariant.
Because of uncertainties, some authors have focused on the characteristic anatomic and hemodynamic findings, referring to them asnutcracker phenomenon rather than nutcracker syndrome (4).
The nutcracker syndrome refers to compression of left renal vein between the superior mesenteric artery and aorta.
Keywords: Nutcracker syndrome, left renal vein entrapment, renal abscess, haematuria, fever.
The nutcracker syndrome (NCS) is the clinical equivalent of NCP and is characterised by various symptoms such as haematuria, proteinuria, flank pain, pelvic congestion orvaricocele.
5] The donor in this case underwent a left nephrectomy, although no signs of the nutcracker syndrome were present on preoperative imaging.
Nutcracker syndrome refers to the compression of the left renal vein between the aorta and the superior mesenteric artery, which results in elevated left renal vein pressure and possible collateral vein development.
Nutcracker syndrome can have several clinical manifestations.
2) Nutcracker syndrome should be part of the differential consideration in the evaluation for hematuria when other etiologies have been excluded.
5) The sagittal plane is especially useful for evaluation of nutcracker syndrome.
5) The transposition of the left renal vein to a more caudal location has been successfully used in nutcracker syndrome.