How I treat nutcracker syndrome.
Flank pain
Hematuria
Inferior vena cava
Nutcracker
Renal vein
Journal
Journal of vascular surgery cases and innovative techniques
ISSN: 2468-4287
Titre abrégé: J Vasc Surg Cases Innov Tech
Pays: United States
ID NLM: 101701125
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
15
05
2023
accepted:
20
09
2023
medline:
6
12
2023
pubmed:
6
12
2023
entrez:
6
12
2023
Statut:
epublish
Résumé
Anatomic compression of the left renal vein in the angle between the aorta and superior mesenteric artery may be asymptomatic or may result in symptoms, including flank pain, hematuria, or pelvic pain and/or congestion. Patients can be referred to a vascular surgeon due to symptoms and/or radiologic findings. Because symptoms of nutcracker syndrome can be vague and/or nondiagnostic, careful evaluation, assessment, and counseling with patients are required before undertaking intervention, which is often an open surgical procedure. The definitive diagnosis is ideally confirmed with diagnostic venography, including pressure measurements from the left renal vein and inferior vena cava. The optimal treatment includes open decompression of the left renal vein with renal vein transposition or gonadal vein transposition, with or without concomitant management of pelvic varicosities if symptomatic. Because most patients with nutcracker syndrome are young, long-term follow-up with scheduled ultrasound examinations should be maintained.
Identifiants
pubmed: 38054082
doi: 10.1016/j.jvscit.2023.101344
pii: S2468-4287(23)00253-8
pmc: PMC10694584
doi:
Types de publication
Journal Article
Langues
eng
Pagination
101344Informations de copyright
© 2023 The Author.
Déclaration de conflit d'intérêts
None.
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