2014, Number 3
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Rev Cubana Pediatr 2014; 86 (3)
A propos of two nutcracker syndrome cases
Campañá CNG, Durán ÁS, Abradelo RAF, Díaz ZN, Hernández HJS
Language: Spanish
References: 19
Page: 390-396
PDF size: 261.37 Kb.
ABSTRACT
Two male patients, who presented with nutcracker syndrome, were reported in this
article. A seven years-old patient went to the doctor´s on account of hematuria and
pain in his left flank whereas a 12 years-old patient suffered recurrent intense pain in
his left flank and orthostatic proteinuria. The renal ultrasonography performed in both
patients showed dilated left renal vein and anomaly of the upper mesenteric artery,
all of which allowed suspecting of this disease. The tomography (angiotac) proved the
vascular anomaly and allowed indicating an expecting symptomatic treatment.
These two patients were seen at the medical service because both presented with the
most frequent symptoms of the syndrome, that is, pain at flanks, macroscopic
hematuria in one and orthostatic proteinuria in the other. Both of them also showed
alterations from a previous nutcracker event. The renal ultrasound to look for dilation
of the left renal vein and the path of the mesenteric artery allows making the final
diagnosis that is further confirmed with other imaging studies.
REFERENCES
Ben Abdullah Chalbchoub R, Chalbchoub K, Maaloul J, Gargouri L, Ben Manfoudh K, Nabil Mhin M, et al. Nutcracker syndrome: a rare cause of hematuria. Arch Pediatr. 2011;18:1188-90.
Vanegas Ruiz JJ, Baquero Rodríguez R, Arteaga Arteaga A, Vélez Moncada E, Brand Salazar S, Rodríguez Ramírez LE, et al. Síndrome de Nutcracker como causa de hematuria en adolescentes: informe de dos casos y revisión de la literatura. NefroPlus. 2009;2:41-4.
Marques GL, Carvalho JG, Nascimento MM, Marks SG, Olbertz LG. Nutcracker syndrome as a cause of recurrent hematuria in a young woman: a case report. J Bras Nefrol. 2012;34:195-8.
Durán Álvarez S. Fenómeno y síndrome de cascanueces asociado a hematuria y proteinuria ortostática. Rev Cubana Pediatr [serie en Internet]. 2013 [citado 28 de noviembre de 2013];85(2). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034- 75312013000200011&lng=es&nrm=iso&tlng=es
Kurklinsky AK, Rooke TW, Nutcracker phenomenon and nutcracker syndrome. Mayo Clin Proc. 2010;85:552-9.
Rudolff V, Holmes RI, Prem JT, Faust GR, Moldwin R, Siegel D. Mesoaortic compression of the left renal vein (nutcracker syndrome): case report and review of the literature. Ann Vas Surg. 2006;20:120-9.
Unlu M, Orguc S, Serter S, Pekindil C, Pabascu Y. Anatomic and hemodynamic evaluation of renal venous flow in varicocele formation using color Doppler Sonography with emphasis on renal vein entrapment syndrome. Scand J Urol Nephrol. 2007;41:42-6.
Tabahashi Y, Sato A, Matsoo M. An ultrasonographic classification for diverse clinical symptoms of pediatric nutcracker phenomenon. Clin Nephrol. 2005;64:47-54.
Alyagut D, Bayram M, Soylu A, Cakmakci H, Türkmen M, Kavukcu S. Clinical course of children with nutcracker syndrome. Urology. 2013;82:686-90.
Waseem M, Upadhyay R, Prosper G. The nutcracker syndrome: an underrecognized cause of hematuria. Eur J Pediatr. 2012;171:1269-71.
Calado R, Braz M, Lobo L, Simao C. Nutcracker syndrome: hematuria without diagnosis? Acta Med Port. 2011;Suppl 3:695-8.
Hanna HE, Santella RN, Sawada ET, Masterson TE. Nutcracker syndrome: an underdiagnosed cause of hematuria. SDJ Med. 1997;50:429-36.
Wendel RG, Crawford ED, Hehman KN. The "nutcracker" phenomenon: an unusual cause for renal varicosities with hematuria. J Urol. 1980;123:761-3.
Shokier AA, El-Diasty TA, Ghoneim MA. The nutcracker syndrome: New methods of diagnosis and treatment. Br J Med. 1994;149:43.
Lee SJ, Lee SJ, You ES, Lee JE, Chung EC. Left renal entrapment in two girls with orthostatic proteinuria. Pediatr Nephrol. 1997;11:218-20.
Venkatachalam S, Bumpus K, Kapadia SR, Gray B, Lyden S, Shishehbor HR. The nutcracker syndrome. Chin J Ultrasonogr. 2011;13(5):363-5.
Baldi S, Rabelino M, Zander T, González G, Maynar M. Endovascular treatment of the nutcracker syndrome. Ann Vasc Surg. 2011;25:1154-64.
Li H, Sun X, Liu G, Zhang Y, Chu J, Deng C, et al. Endovascular stent placement for nutcracker phenomenon. J Xray Sci Technol. 2013;21:95-102.
Dever DP, Ginsburg ME, Millet DJ, Cockett AT. Nutcracker. Phenomenon. 1986;27:540-2.