Nutcracker syndrome in nephrology practice
DOI: https://dx.doi.org/10.18565/nephrology.2019.2.44-48
E.A. Movchan, Ya.L. Manakova, E.V. Galkina, T.A. Telegina
1) Novosibirsk State Medical University, Novosibirsk, Russia;
2) State Novosibirsk Regional Clinical Hospital, Novosibirsk, Russia
Nutcracker syndrome is a consequence of aorto-mesenteric compression of the left renal vein – compression of the left renal vein by the superior mesenteric artery with the development of left-sided renal phlebohypertension, pain in the left side and small pelvis, the appearance of proteinuria and hematuria. The relative rarity of the disease, the lack of clear clinical diagnostic criteria, the possible latent course with isolated urinary syndrome can lead to diagnostic errors. The article presents two cases of nutcracker syndrome, confirmed by data of multispiral computed tomography in 17- and 20-years old patients old, previously suffering from varicocele. Renal biopsy results excluded the suspected chronic glomerulonephritis as the cause of isolated urinary syndrome. The necessity of including aorto-mesenteric compression of the left renal vein with the development of renal venous hypertension in the diagnostic algorithm in patients with isolated urinary syndrome is emphasized.
Keywords: nutcracker syndrome, aorto-mesenteric compression of the left renal vein, renal venous hypertension, urinary syndrome, multispiral computed tomography
About the Autors
Movchan E.A. – PhD in Medical Sciences, Professor of the Department of Internal Diseases n.a. Acad. L.D. Sidorov, Novosibirsk State Medical University, Novosibirsk, Russia.
E-mail: eamovchan@gmail.com
Manakova Ya.L. – PhD in Medical Sciences, Head of the X-ray Department, State Novosibirsk Regional Clinical Hospital, Associate Professor at the Department of Radiology Diagnostics, Novosibirsk State Medical University; Novosibirsk, Russia.
Galkina E.V. – Chief Nephrologist of the Novosibirsk Region, Head of the Nephrology Department, State Novosibirsk Regional Clinical Hospital; Novosibirsk, Russia.
Telegina TA – PhD in Medical Sciences, Anatomopathologist at the Department of Morbid Anatomy, State Novosibirsk Regional Clinical Hospital; Novosibirsk, Russia.
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