Key words: Nutcracker syndrome; Renal vein entrapment; Hematuria; Orthostatic proteinuria; Left renal vein hypertension
Core tip: The nutcracker phenomenon [left renal vein (LRV) entrapment syndrome] refers to compression of the LRV most commonly between abdominal aorta and superior mesenteric artery. Term of nutcracker syndrome (NCS) is used for patients with clinical symptoms associated with nutcracker anatomy. The symptoms vary from asymptomatic hematuria to severe pelvic congestion. The management of NCS depends upon the clinical presentation and the severity of the LRV hypertension.
Gulleroglu K, Gulleroglu B, Baskin E. Nutcracker syndrome. World J Nephrol 2014; In press
INTRODUCTION
The nutcracker phenomenon [left renal vein (LRV) entrapment syndrome] refers to compression of the LRV most commonly between abdominal aorta and superior mesenteric artery. This phenomenon is characterized by impeded outflow from the LRV into the inferior vena cava (IVC) due to extrinsic compression.
The terms nutcracker phenomenon and nutcracker syndrome (NCS) are sometimes used as synonym in the literature. Nutcracker phenomenon descript anatomic findings suggestive of nutcracker are present without clinical symptoms. Term of NCS is used for patients with clinical symptoms associated with nutcracker anatomy.
Diagnosis of NCS could be difficult for some reasons. It was thought to be a rare condition. Also in the absence of clinical features it was necessitate a high suspicion. A noninvasive imaging must be followed by an invasive imaging for confirmation of the diagnosis.
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