Mesoaortic Compression of the Left Renal Vein (Nutcracker Syndrome): Case Reports and Review of the Literature

  title={Mesoaortic Compression of the Left Renal Vein (Nutcracker Syndrome): Case Reports and Review of the Literature},
  author={Udo Rudloff and Raymond J. Holmes and Jeffrey T Prem and Glenn R. Faust and Robert Moldwin and David N. Siegel},
  journal={Annals of Vascular Surgery},
Compression of the left renal vein between the aorta and the superior mesenteric artery has been termed the nutcracker syndrome. Obstruction of left renal vein outflow results in venous hypertension with the formation of intra- and extrarenal collaterals and/or the development of gonadal vein reflux. To date, a variety of clinical symptoms due to mesoaortic compression of the left renal vein (nutcracker syndrome) have been described. It is not known what pathophysiological variables play a role… 

Co-occurring superior mesenteric artery syndrome and nutcracker syndrome requiring Roux-en-Y duodenojejunostomy and left renal vein transposition: a case report and review of the literature

This report describes a case of a patient with both types of aortomesenteric compression that required two separate surgeries to alleviate all symptoms and called for Guidance for health care professionals with respect to relevant radiological and clinical markers needs to be reconsidered.

Case report of gross hematuria in the nutcracker syndrome resolved by renocaval reimplantation.

This case report demonstrates that renocaval reimplantation, as the open surgery technique, could be the adequate method for resolving gross hematuria in patients with nutcracker syndrome.

Serial ganglion impar blocks in a patient with nutcracker syndrome refractory to left renal vein transposition: a case report

A 22-year-old Caucasian man with a known diagnosis of nutcracker syndrome had undergone left renal vein transposition 1 year before presentation without any subsequent pain relief, and was not amenable to further surgical intervention or stenting to treat his underlying pathology.

Renosplenic shunting in the nutcracker phenomenon: a discussion and paradigm shift in options? A novel approach to treating nutcracker syndrome.

A case of spontaneous renosplenic shunting in a 68-year-old lady of Chinese descent with the nutcracker syndrome is presented-the first of such cases to be ever reported in a patient with no preexisting predilection for chronic liver disease and portosystemic shunting.

Posterior nutcracker syndrome with left renal vein duplication as a cause of gross hematuria and recurrent left varicocele in an eight-year-old boy

Although posterior nutcracker syndrome with duplication of the left renal vein is a rare entity, it is often misdiagnosed because it embraces an extended non-pathognomonic spectrum of symptoms which imply a difficult diagnosis.

Laparoscopic Duodenojejunostomy for Superior Mesenteric Vein Syndrome Associated with Nutcracker Phenomenon: The First Case Report

Vascular compression of the duodenum presents with manifestations of proximal small bowel obstruction, which may have chronic, intermittent, or acute symptoms.

Posterior Nutcracker Syndrome with Left Renal Vein Duplication: A Rare Cause of Haematuria in a 12-Year-Old Boy

A rare cause if a 12-year-old boy who presented with a history of frequent intermittent episodes of painless constant haematuria is reported, with haemoglobin value returning to normal and therefore proposed to conservative management with close followup.

Mixed nutcracker syndrome with left renal vein duplication: A severe and exceptional presentation in an 18-year-old boy

A rare case of an 18-year-old boy who presented with a long history of abdominal, pelvic and left flank pain, fatigue and higher bilateral varicocele, andAuto transplantation of the left kidney was suggested, but refused by the patient; and only thevaricocele was managed.



Nutcracker syndrome: an overlooked cause of hematuria.

Magnetic resonance angiography is a safe and reliable tool for diagnosing nutcracker syndrome, which is easily missed by routine diagnostic methods and results in left renal venous hypertension and hematuria.

Gross hematuria of uncommon origin: the nutcracker syndrome.

The diagnosis of "nutcracker phenomenon" was confirmed by renal venography with measurement of pressure gradient between left renal vein and inferior vena cava in both cases and the diagnosis was complicated by the presence of Mycobacterium tuberculosis in urine.

The nutcracker syndrome: its role in the pelvic venous disorders.

The nutcracker syndrome should be considered in women with symptoms of pelvic venous congestion and hematuria and internal and external renal stenting as well as gonadocaval bypass are effective methods of treatment of the nutcrackers syndrome.

Nutcracker syndrome: intravascular stenting approach.

  • Y. B. ParkS. H. Lim S. H. Yu
  • Medicine
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
  • 2000
A middle-aged man with Nutcracker syndrome accompanied by renal enlargement, persistent haematuria, proteinuria and hypertension with a new intravascular stent is satisfactorily treated.