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Organo Oficial de la Sociedad Mexicana de Urología

2010, Number 1

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Rev Mex Urol 2010; 70 (1)

Nutcracker syndrome: a case report

Dellavedova T, Racca L, Ponzano RM, Minuzzi S, Olmedo JJ, Minuzzi G

Language: Spanish
References: 14
Page: 51-54
PDF size: 229.03 Kb.


ABSTRACT

Background: The Nutcracker Syndrome is a compression of the left renal vein (LRV) by the abdominal aorta (AA) and the superior mesenteric artery (SMA). It is manifested by pain, hematuria, varicocele or lower or pelvic urinary symptoms. There are less than 200 cases published in the literature.
Materials and methods: The patient is a 15-year-old boy who presented with a 2-year progression of pain in the lumbar fossa and left flank. Ultrasonogram revealed dilated LRV and Doppler sonogram and multislice CAT detected obstruction, ectasia and increased blood flow at the LRV level.
Results: Given symptom intermittence and scant interference with patient’s daily activities, patient was left under surveillance with periodic control.
Conclusions: Incidence of this disease is low. It should be suspected in young men or women with symptoms of long duration and who present with no other suspicious pathology. Open surgery is presently the most indicated treatment and extensive follow-up is required to confirm long-term endovascular treatment results.


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