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Case Reports
. 2020:77:730-732.
doi: 10.1016/j.ijscr.2020.11.088. Epub 2020 Nov 20.

Nutcracker syndrome due to aorto-mesenteric compression in adults: Case report and literature review

Khalid Elhattabi  1 , Abdelilah Elbakouri  1 , Mohamed Ouchane  2 , Mounir Bouali  1 , Fatimazahra Bensardi  1 , Abdelaziz Fadil  1
Affiliations
Case Reports

Nutcracker syndrome due to aorto-mesenteric compression in adults: Case report and literature review

Khalid Elhattabi et al. Int J Surg Case Rep. 2020.

Abstract

Nutcracker syndrome is a rare entity that corresponds to an abdominal pain following compression of the left renal vein during its passage between the aorta and the superior mesenteric artery, with a peak prevalence in adults between 20 and 30 years old, The typical clinical presentation includes hematuria, orthostatic proteinuria with or without flank pain. doppler ultrasound has a sensitivity of 78% and specificity of 100%, Both CT and MRI can show the compression of the left renal vein between the aorta and the superior mesenteric artery. We report the case of a young patient admitted to the emergency room for abdominal pain mainly localized in the left hypochondrium, with microscopic hematuria, a CT scan was performed showing a reduced aorto mesenteric angle with a compression of the left renal vein and collateralization of venous circulation of left gonadal vein.

Keywords: Aorto-mesenteric region; Left renal vein; Nutcracker syndrome; Surgery.

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Figures

Fig. 1
Fig. 1
(A) an axial CT showing the beak sign with an upper aorto-mesenteric angle measured at 14.2° (red arrow). (B) Curved image demonstrating Beak Sign at the aortomesenteric portion of the left renal vein.
Fig. 2
Fig. 2
CT scan showing a varicose dilatation of the left gonadal vein (arrow).
See this image and copyright information in PMC

References

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