Infrarenal Abdominal Aorta Aneurysm: A Rare Cause of Anterior Nutcracker Syndrome with Associated Pelvic Congestion

Lozuk, Branko; Tanasković, Slobodan; Radak, Djordje; Babić, Srdjan; Kovacevic, Vladimir; Matić, Predrag

doi:10.1016/j.avsg.2012.11.019

Cited by 6 publications

(2 citation statements)

References 20 publications

(12 reference statements)

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“…To our knowledge, so far no case has been reported with aortomegaly resulting in anterior NCS and eventual PCS that was managed by endovascular approach. However, a similar case with surgical management was reported recently by Lozuk et al, 10 where an abdominal aortic aneurysm was resulting in NCS and engorged left ovarian vein. This was treated surgically by aneurysm resection, followed by left ovarian vein ligation and left adnexectomy.…”

Section: Discussionsupporting

confidence: 76%

Aortomegaly Causing Nutcracker Syndrome and Pelvic Congestion Syndrome

Rathod¹,

Sahu²,

Popat³

et al. 2018

J Clin Interv Radiol ISVIR

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The authors present an uncommon cause of pelvic congestion syndrome (PCS) secondary to anterior nutcracker syndrome, which was caused by aortomegaly. Positional flank and pelvic pain was the only presenting feature with no renal dysfunction. Early and significant decompression of left renal vein (LRV) via left ovarian vein resulted in preserved renal function with symptomatic pelvic varices. Endovascular management by left ovarian vein coiling and LRV stenting was done. They briefly review the etiopathology, imaging, treatment rationale, and management options for nutcracker and PCS.

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Section: Discussionsupporting

confidence: 76%

Aortomegaly Causing Nutcracker Syndrome and Pelvic Congestion Syndrome

Rathod¹,

Sahu²,

Popat³

et al. 2018

J Clin Interv Radiol ISVIR

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“…This could lead to nutcracker-syndrome or obstructive uropathy. [ 3 , 4 ] In our case, the AAA with its thrombotic and calcified deposits led to a decreased perfusion of the kidneys and therefore to renal failure. Creatinine levels and creatinine clearance were normal when the patient underwent the pacemaker implantation 3 years ago and in the last pacemaker control 1 year ago.…”

Section: Discussionmentioning

confidence: 65%

Renal failure caused by a partly calcified aortic aneurysm in a patient with dabigatran therapy

Jud¹,

Tse²,

Tiesenhausen

et al. 2017

Medicine

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Rationale:Abdominal aortic aneurysms (AAAs) are mostly asymptomatic. If aortic aneurysms become symptomatic, complications include peripheral embolization, acute aortic occlusion, and aortic rupture. However, there are also unusual complications caused by aortic aneurysms.Patient concerns:An 87-old male with dabigatran therapy presented with newly developed melena and acute renal failure. Radiological imaging revealed an AAA with thrombotic and calcified deposits which affected the renal arteries.Diagnoses:Gastrointestinal bleeding and hypercoagulation caused by renal failure which was triggered in turn due to an AAA.Interventions:Adapted antihypertensive therapy and initiation of simvastatin 40mg once daily as well as antiplatelet therapy with aspirin 50 mg once daily due to patient's refusal of any aneurysm intervention.Outcome:Neither bleeding event nor aneurysm rupture occurred with the adapted antihypertensive therapy, simvastatin and aspirin.Lessons:Nonruptured AAAs can cause rare, unusual, and even life-threatening complications depending on their size and anatomical position.

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