Diagnosis and therapeutic strategies for nutcracker syndrome

Reyes, Thomas de Los; Keefe, Daniel T.; Rickard, Mandy; Lorenzo, Armando J.

doi:10.1097/mou.0000000000000831

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…In these evaluations, when malignancies, stones, arteriovenous malformations are excluded and NCS is considered, it is recommended to rst perform RDU, which has a sensitivity and speci city of 69-90% and 89-100%, respectively, due to its non-invasive nature [1,3,6,14]. CT and magnetic resonance imaging (MRI) are useful because they provide simultaneous condition of surrounding tissues and anatomical correlation.…”

Section: Discussionmentioning

confidence: 99%

“…Medical treatment also has a place in patients at risk of venous thrombosis [13]. Treatment of NCS includes open, laparoscopic and robotic surgical repair and endovascular/extravascular stent placement [1,3]. Endovascular stent placement is the most common and rst choice [9,11].…”

Section: Discussionmentioning

confidence: 99%

“…Nutcracker syndrome(NCS) is a condition with typical clinical ndings that occurs secondary to compression of the left renal vein(LRV) between the abdominal aorta(AA) and superior mesenteric artery(SMA) [1]. In the presence of the same anatomical variation but no clinical symptoms or signs, this situation is called Nutcracker phenomenon(NCP) [2,3].…”

Section: Introductionmentioning

confidence: 99%

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Nutcracker syndrome: First case causing left renal intraparenchymal varicose veins

Uğur,

Şimşek

2024

Preprint

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Purpose Our aim in this case is to report a new finding regarding Nutcracker syndrome (NCS), which is a variation of the left renal vein. Methods We present a very rare anatomical variant of the left renal vein(LRV), with a preliminary diagnosis made by ultrasound and NCS as a differential diagnosis with computed tomography (CT) and diagnostic CT angiography. Results The patient in our case was a 30-year-old woman with chronic abdominal and flank pain and increased sensitivity in the flank area. Neither hematuria nor proteinuria was detected in the urinalysis. Contrast-enhanced computed tomography(CT) showed that there were two separate LRVs draining the lower and upper poles. It was observed that the vein draining the lower pole narrowed significantly between superior mesenteric artery and abdominal aorta and then continued to widen. This view showed that we were faced with a typical NCS. What made our case different and unique from typical NCS was that it had renal intraparenchymal varicose veins. Treatment of NCS includes open, laparoscopic and robotic surgical repair and endovascular/extravascular stent placement. Treatment of symptomatic NCS includes open, laparoscopic, and robotic surgical repair and endovascular/extravascular stent placement. Except for the presence of hematuria causing severe anemia, deterioration in kidney functions and serious pain, patients are followed conservatively, and our patient is also followed conservatively. Conclusion This case we present is the first case accompanied by renal parenchymal varices in the literature.

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Section: Discussionmentioning

confidence: 99%