Nutcracker syndrome history and symptoms

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

Overview

Symptoms

The syndrome is associated with hematuria, which can lead to anemia[1], abdominal complaints or pain[2] (classically left flank pain[3]), 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 testicular pain[2] in men or left lower quadrant pain in women.

Unusual manifestations of the nutcracker syndrome include varicocele formation and varices in the lower limbs.[4]

References

  1. Oteki T, Nagase S, Hirayama A, Sugimoto H, Hirayama K, Hattori K, Koyama A. Nutcracker syndrome associated with severe anemia and mild proteinuria. Clin Nephrol. 2004 Jul;62(1):62-5. PMID 15267016.
  2. 2.0 2.1 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.
  3. 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
  4. Little AF, Lavoipierre AM. Unusual clinical manifestations of the Nutcracker Syndrome. Australasian Radiol. 2002 Jun;46(2):197-200. PMID 12060163.