User:Mr. Ibrahem/Nutcracker syndrome
| Nutcracker syndrome | |
|---|---|
| Other names | Nutcracker phenomenon, left renal vein entrapment syndrome, mesoaortic compression of the left renal vein |
 | |
| The nutcracker syndrome results from compression of the left renal vein between the aorta and the superior mesenteric artery. | |
| Specialty | Nephrology |
| Symptoms | None, blood in the urine, flank pain, pelvic pain, lightheadedness with standing[1] |
| Complications | Thrombosis of the left renal vein, varicocele, kidney problems[1] |
| Causes | Compression of the renal vein[1] |
| Risk factors | Retroperitoneal cancers, abdominal aortic aneurysm, low body mass index, lordosis, enlarged lymph nodes around the aorta[1] |
| Diagnostic method | Suspected based on symptoms, confirmed by medical imaging after ruling out other possible causes[1] |
| Differential diagnosis | Kidney stones, pyelonephritis, renal cell carcinoma[2] |
| Treatment | Conservative, weight gain, surgery[1][2] |
| Frequency | Unclear[1] |
Nutcracker syndrome (NCS) is a condition that occurs when the left vein from the kidney becomes compressed.[1] Some may have no symptoms, while other develop blood in the urine, flank pain, pelvic pain, or lightheadedness with standing.[1] Males may develop a varicocele on the left side.[1] Other complications may include clotting of the vein, and kidney problems.[1]
Compression most commonly occurs between the abdominal aorta (AA) and superior mesenteric artery (SMA), though compression may also occur between the aorta and spine.[3][1] Risk factors include retroperitoneal cancers, abdominal aortic aneurysm, low body mass index, lordosis, and enlarged lymph nodes around the aorta.[1] Diagnostic may be suspected based on symptoms and confirmed by medical imaging after ruling out other possible causes.[1] Superior mesenteric artery syndrome is a different condition in which the duodenum is compressed between the the SMA and AA.[4]
How best to treat the condition is often not clear.[1] If symptoms are mild conservative management and weight gain in those who are slender may be recommended.[1][2] Surgery may be recommended if the urine is visibly bloody, significant dysfunction occurs, or the condition does not improve after 6 to 24 months of observation.[1] Surgery may involve the placement of an endovascular stent, be done laparoscopically, or with an open technique.[1] In children the condition may resolve with time.[2]
While it has been described as rare, how commonly it occurs is not clear.[1] Onset is most often in peoples 20s to 30s.[2] The condition was first described in 1937 by Grant.[5][3] The term itself; however, did not come into use until 1971 by Chait.[3] The name derives from the compression of the vein appearing to be a nutcracker crushing a nut.[6]
References[edit]
- ^ a b c d e f g h i j k l m n o p q r s "Renal nutcracker syndrome". rarediseases.info.nih.gov. Genetic and Rare Diseases Information Center (GARD) – an NCATS Program. Retrieved 10 February 2021.
- ^ a b c d e Penfold, D; Lotfollahzadeh, S (January 2020). "Nutcracker Syndrome". PMID 32644615.
{{cite journal}}: Cite journal requires|journal=(help) - ^ a b c Kurklinsky AK, Rooke TW (June 2010). "Nutcracker phenomenon and nutcracker syndrome". Mayo Clinic Proceedings. 85 (6): 552–9. doi:10.4065/mcp.2009.0586. PMC 2878259. PMID 20511485.
- ^ "Superior mesenteric artery syndrome Genetic and Rare Diseases Information Center (GARD) – an NCATS Program". rarediseases.info.nih.gov. Retrieved 10 February 2021.
- ^ Cheng, Christopher (2019). Handbook of Vascular Motion. Academic Press. p. 178. ISBN 978-0-12-815714-5.
- ^ Daniel, Achoki. "Superior mesenteric artery syndrome with associated nutcraker syndrome | Radiology Case | Radiopaedia.org". Radiopaedia. Retrieved 10 February 2021.