Nutcracker syndrome due to aorto-mesenteric compression in adults: Case report and literature review. (2020)

• Record Type: Journal Article
• Authors: Elhattabi, Khalid; Elbakouri, Abdelilah; Ouchane, Mohamed; Bouali, Mounir; Bensardi, Fatimazahra; Fadil, Abdelaziz
• Is Part Of: International journal of surgery case reports. Volume 77(2020)
• Page Start: 730
• Page End: 732
• Publication Date: 2020
• Subjects: Nutcracker syndrome -- Left renal vein -- Aorto-mesenteric region -- Surgery; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2020.11.088
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Nutcracker syndrome is characterized by compression of the left renal vein between the abdominal aorta and the superior mesenteric artery, resulting in an obstruction of blood flow from the left renal vein into the inferior vena cava due to extrinsic compression. The management of nutcracker syndrome depends on the clinical presentation and severity of hypertension in the left renal vein, ranging from simple monitoring to nephrectomy. Surgical techniques used for the treatment of patients with severe symptoms. Abstract: Nutcracker syndrome is a rare entity that corresponds to an abdominal pain following compression of the left renal vein during its passage between the aorta and the superior mesenteric artery, with a peak prevalence in adults between 20 and 30 years old, The typical clinical presentation includes hematuria, orthostatic proteinuria with or without flank pain. doppler ultrasound has a sensitivity of 78% and specificity of 100%, Both CT and MRI can show the compression of the left renal vein between the aorta and the superior mesenteric artery. We report the case of a young patient admitted to the emergency room for abdominal pain mainly localized in the left hypochondrium, with microscopic hematuria, a CT scan was performed showing a reduced aorto mesenteric angle with a compression of the left renal vein and collateralization of venous circulation of left gonadal vein.