Nutcracker syndrome: Difference between revisions

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	Nutcracker syndrome;
DiseasesDB	32367

VisualWikitext

Latest revision as of 18:46, 27 September 2012

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: nutcracker phenomenon; renal vein entrapment syndrome; mesoaortic compression of the left renal vein

Overview

Historical Perspective

Pathophysiology

Differentiating Nutcracker syndrome from other Diseases

Epidemiology and Demographics

Natural History, Complications and Prognosis

Diagnosis

Treatment

Medical Therapy | Surgery | Primary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

External Links

Article on nutcracker phenomenon at the New England Journal of Medicine website.

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+{{SK}} nutcracker phenomenon; renal vein entrapment syndrome; mesoaortic compression of the left renal vein
-In [[medicine]], the '''nutcracker syndrome''' — also known as '''nutcracker phenomenon''', '''renal vein entrapment syndrome,''' or '''mesoaortic compression of the left renal vein''' — is a compression of the left [[renal vein]] between the [[abdominal aorta]] (AA) and [[superior mesenteric artery]] (SMA).<ref>Sugimoto I, Takashi O, Ishibashi H, Takeuchi N, Nagata Y, Honda Y. Left Renal Vein Entrapment Syndrome (Nutcracker Syndrome) treated with Left Renal Vein Transposition. Jnp J Vasc Surg. 2001 10:503-507. [http://www.jsvs.org/en/journal/abstract.php?bn=20011004&no=8 Abstract].</ref>  The popular name "nutcracker syndrome" derives from the fact that, in the [[sagittal view]], the SMA and AA (with some imagination) appear to be a [[nutcracker]] crushing a [[Nut (fruit)|nut]] (the renal vein).
+==[[Nutcracker syndrome overview|Overview]]==
+==[[Nutcracker syndrome historical perspective|Historical Perspective]]==
+==[[Nutcracker syndrome pathophysiology |Pathophysiology]]==
+==[[Nutcracker syndrome differential diagnosis|Differentiating Nutcracker syndrome from other Diseases]]==
+==[[Nutcracker syndrome epidemiology and demographics|Epidemiology and Demographics]]==
+==[[Nutcracker syndrome natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
+==Diagnosis==
+[[Nutcracker syndrome history and symptoms|History and Symptoms]] | [[Nutcracker syndrome physical examination|Physical Examination]] | [[Nutcracker syndrome laboratory findings|Laboratory Findings]] | [[Nutcracker syndrome CT|CT]] | [[Nutcracker syndrome echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Nutcracker syndrome other diagnostic studies|Other Diagnostic Studies]]
-==Signs and symptoms==
+==Treatment==
-The syndrome is associated with [[hematuria]], which can lead to [[anemia]]<ref>Oteki T, Nagase S, Hirayama A, Sugimoto H, Hirayama K, Hattori K, Koyama A. Nutcracker syndrome associated with severe anemia and mild proteinuria.
+[[Nutcracker syndrome medical therapy|Medical Therapy]] | [[Nutcracker syndrome surgery|Surgery]] | [[Nutcracker syndrome primary prevention|Primary Prevention]] | [[Nutcracker syndrome cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Nutcracker syndrome future or investigational therapies|Future or Investigational Therapies]]
-Clin Nephrol. 2004 Jul;62(1):62-5. PMID 15267016.</ref>, [[abdominal pain|abdominal complaints or pain]]<ref name=hilgard_9721569>Hilgard P, Oberholzer K, Meyer zum Buschenfelde KH, Hohenfellner R, Gerken G. [The "nutcracker syndrome" of the renal vein (superior mesenteric artery syndrome) as the cause of gastrointestinal complaints] Dtsch Med Wochenschr. 1998 Jul 31;123(31-32):936-40. PMID 9721569.</ref> (classically left [[flank pain]]<ref name=barnes_3172376>Barnes RW, Fleisher HL 3rd, Redman JF, Smith JW, Harshfield DL, Ferris EJ. Mesoaortic compression of the left renal vein (the so-called nutcracker syndrome): repair by a new stenting procedure. J Vasc Surg. 1988 Oct;8(4):415-21. PMID 3172376</ref>), [[nausea]], and/or [[vomiting]], due to compression of the [[duodenum]] which also passes between the SMA and abdominal aorta). Because the left [[gonad]] drains via the left [[renal vein]], it can also result in left [[testis|testicular]] pain<ref name=hilgard_9721569/> in men or left lower quadrant pain in women.
+==Case Studies==
+:[[Nutcracker syndrome case study one|Case #1]]
-Unusual manifestations of the nutcracker syndrome include [[varicocele]] formation and [[varix|varices]] in the lower limbs.<ref>Little AF, Lavoipierre AM. Unusual clinical manifestations of the Nutcracker Syndrome. Australasian Radiol. 2002 Jun;46(2):197-200. PMID 12060163.</ref>
+== External Links ==
-== Diagnosis ==
-Nutcracker syndrome can be diagnosed with:
-* Left renal [[venography]] — considered to be the [[gold standard (test)|gold standard test]].
-* [[Computed tomography]] (CT).
-* Abdominal [[ultrasonography]] — not definitive but has been found to be useful.<ref>Takebayashi S, Ueki T, Ikeda N, Fujikawa A. Diagnosis of the nutcracker syndrome with color Doppler sonography: correlation with flow patterns on retrograde left renal venography. AJR Am J Roentgenol. 1999 Jan;172(1):39-43. PMID 9888735.</ref>
-== Treatment ==
-Treatment depends on the severity and symptoms.  Treatments include:
-* Endovascular stenting.<ref name=barnes_3172376/>
-* Renal vein re-implantation.<ref name=rudloff_16374539>Rudloff U, Holmes RJ, Prem JT, Faust GR, Moldwin R, Siegel D. Mesoaortic compression of the left renal vein (nutcracker syndrome): case reports and review of the literature. Ann Vasc Surg. 2006 Jan;20(1):120-9. PMID 16374539.</ref>
-* [[Gonadal vein]] [[embolization]].<ref name=rudloff_16374539/>
-== References ==
-<references/>
-Ahmed K, Sampath R, Khan MS. Current trends in the diagnosis and management of renal nutcracker syndrome: a review. Eur J Vasc Endovasc Surg. 2006 Apr;31(4):410-6. Epub 2006 Jan 23.
-== External links ==
 * [http://content.nejm.org/cgi/content/full/335/3/171/F1 Article on nutcracker phenomenon] at the ''[[New England Journal of Medicine]]'' website.
 [[Category:Kidney diseases]]
 [[Category:Radiology]]
 [[Category:Syndromes]]
+[[Category:Nephrology]]
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Nutcracker syndrome
DiseasesDB	32367

Nutcracker syndrome: Difference between revisions

Latest revision as of 18:46, 27 September 2012

Overview

Historical Perspective

Pathophysiology

Differentiating Nutcracker syndrome from other Diseases

Epidemiology and Demographics

Natural History, Complications and Prognosis

Diagnosis

Treatment

Case Studies

External Links

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