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KEY FACTS
Terminology
Imaging
Pathology
Clinical Issues
TERMINOLOGY
Definitions
- Compression of left renal vein between aorta and superior mesenteric artery (SMA)
- Causes left renal venous outflow obstruction
- Results in left renal venous hypertension
- May have accompanying hematuria
- May have engorged edematous left kidney with intrarenal/perirenal varices
- Secondary pelvic congestion syndrome may occur
- Due to retrograde flow in left gonadal vein
- Results in left renal venous hypertension
- Causes left renal venous outflow obstruction
- Compression of left renal vein between aorta and superior mesenteric artery (SMA)
IMAGING
General Features
Imaging Recommendations
Ultrasonographic Findings
CT Findings
MR Findings
Angiographic Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Wang X et al: Results of endovascular treatment for patients with nutcracker syndrome. J Vasc Surg. 56(1):142-8, 2012
- Chen S et al: Endovascular stenting for treatment of Nutcracker syndrome: report of 61 cases with long-term followup. J Urol. 186(2):570-5, 2011
- Fitoz S et al: Nutcracker syndrome in children: the role of upright position examination and superior mesenteric artery angle measurement in the diagnosis. J Ultrasound Med. 26(5):573-80, 2007
- Scholbach T: From the nutcracker-phenomenon of the left renal vein to the midline congestion syndrome as a cause of migraine, headache, back and abdominal pain and functional disorders of pelvic organs. Med Hypotheses. 68(6):1318-27, 2007
- Shin JI et al: Doppler ultrasonographic indices in diagnosing nutcracker syndrome in children. Pediatr Nephrol. 22(3):409-13, 2007
- Zhang H et al: The left renal entrapment syndrome: diagnosis and treatment. Ann Vasc Surg. 21(2):198-203, 2007
- Ahmed K et al: Current trends in the diagnosis and management of renal nutcracker syndrome: a review. Eur J Vasc Endovasc Surg. 31(4):410-6, 2006
- Culafic D et al: Spontaneous splenorenal shunt in a patient with liver cirrhosis and hypertrophic caudal lobe. J Gastrointestin Liver Dis. 15(3):289-92, 2006
- Rudloff U et al: Mesoaortic compression of the left renal vein (nutcracker syndrome): case reports and review of the literature. Ann Vasc Surg. 20(1):120-9, 2006
- Chang CT et al: Nutcracker syndrome and left unilateral haematuria. Nephrol Dial Transplant. 20(2):460-1, 2005
- Cuellar i Calabria H et al: Nutcracker or left renal vein compression phenomenon: multidetector computed tomography findings and clinical significance. Eur Radiol. 15(8):1745-51, 2005
- Kim SJ et al: Long-term follow-up after endovascular stent placement for treatment of nutcracker syndrome. J Vasc Interv Radiol. 16(3):428-31, 2005
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Pathology
Clinical Issues
TERMINOLOGY
Definitions
- Compression of left renal vein between aorta and superior mesenteric artery (SMA)
- Causes left renal venous outflow obstruction
- Results in left renal venous hypertension
- May have accompanying hematuria
- May have engorged edematous left kidney with intrarenal/perirenal varices
- Secondary pelvic congestion syndrome may occur
- Due to retrograde flow in left gonadal vein
- Results in left renal venous hypertension
- Causes left renal venous outflow obstruction
- Compression of left renal vein between aorta and superior mesenteric artery (SMA)
IMAGING
General Features
Imaging Recommendations
Ultrasonographic Findings
CT Findings
MR Findings
Angiographic Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Wang X et al: Results of endovascular treatment for patients with nutcracker syndrome. J Vasc Surg. 56(1):142-8, 2012
- Chen S et al: Endovascular stenting for treatment of Nutcracker syndrome: report of 61 cases with long-term followup. J Urol. 186(2):570-5, 2011
- Fitoz S et al: Nutcracker syndrome in children: the role of upright position examination and superior mesenteric artery angle measurement in the diagnosis. J Ultrasound Med. 26(5):573-80, 2007
- Scholbach T: From the nutcracker-phenomenon of the left renal vein to the midline congestion syndrome as a cause of migraine, headache, back and abdominal pain and functional disorders of pelvic organs. Med Hypotheses. 68(6):1318-27, 2007
- Shin JI et al: Doppler ultrasonographic indices in diagnosing nutcracker syndrome in children. Pediatr Nephrol. 22(3):409-13, 2007
- Zhang H et al: The left renal entrapment syndrome: diagnosis and treatment. Ann Vasc Surg. 21(2):198-203, 2007
- Ahmed K et al: Current trends in the diagnosis and management of renal nutcracker syndrome: a review. Eur J Vasc Endovasc Surg. 31(4):410-6, 2006
- Culafic D et al: Spontaneous splenorenal shunt in a patient with liver cirrhosis and hypertrophic caudal lobe. J Gastrointestin Liver Dis. 15(3):289-92, 2006
- Rudloff U et al: Mesoaortic compression of the left renal vein (nutcracker syndrome): case reports and review of the literature. Ann Vasc Surg. 20(1):120-9, 2006
- Chang CT et al: Nutcracker syndrome and left unilateral haematuria. Nephrol Dial Transplant. 20(2):460-1, 2005
- Cuellar i Calabria H et al: Nutcracker or left renal vein compression phenomenon: multidetector computed tomography findings and clinical significance. Eur Radiol. 15(8):1745-51, 2005
- Kim SJ et al: Long-term follow-up after endovascular stent placement for treatment of nutcracker syndrome. J Vasc Interv Radiol. 16(3):428-31, 2005
