OBJECTIVE: To study the pathophysiology of the nutcracker syndrome and to describe a new method of treatment. SUBJECTS AND METHODS: Computerized tomography (CT) was used to compare the anatomical relations of the left renal vein with the aorta and the superior mesenteric artery in three patients with the nutcracker syndrome and in a control group of 12 healthy kidney donors. RESULTS: Abnormal branching of the superior mesenteric artery from the aorta was identified as the cause of the nutcracker syndrome. Two patients were treated by autotransplantation of the left kidney, while the third refused surgery. In the treated patients haematuria ceased 4 and 6 weeks after surgery. Postoperative excretory urography and repeated isotopic studies revealed perfect configuration and function of the autotransplanted kidneys. The patients remain asymptomatic 6 and 12 months after surgery. CONCLUSION: In patients with haematuria from the left kidney, angiographic CT must be considered before phlebography and pressure measurement of the left renal vein. If the diagnosis of the nutcracker syndrome is established, autotransplantation of the left kidney is a treatment alternative.
OBJECTIVE: To study the pathophysiology of the nutcracker syndrome and to describe a new method of treatment. SUBJECTS AND METHODS: Computerized tomography (CT) was used to compare the anatomical relations of the left renal vein with the aorta and the superior mesenteric artery in three patients with the nutcracker syndrome and in a control group of 12 healthy kidney donors. RESULTS: Abnormal branching of the superior mesenteric artery from the aorta was identified as the cause of the nutcracker syndrome. Two patients were treated by autotransplantation of the left kidney, while the third refused surgery. In the treated patientshaematuria ceased 4 and 6 weeks after surgery. Postoperative excretory urography and repeated isotopic studies revealed perfect configuration and function of the autotransplanted kidneys. The patients remain asymptomatic 6 and 12 months after surgery. CONCLUSION: In patients with haematuria from the left kidney, angiographic CT must be considered before phlebography and pressure measurement of the left renal vein. If the diagnosis of the nutcracker syndrome is established, autotransplantation of the left kidney is a treatment alternative.
Authors: Federica A Vianello; Marta B M Mazzoni; Gabriëlla G A M Peeters; Emilio F Fossali; Pietro Camozzi; Mario G Bianchetti; Gregorio P Milani Journal: Pediatr Nephrol Date: 2015-01-28 Impact factor: 3.714
Authors: Jung-Eun Cheon; Woo Sun Kim; In-One Kim; Seung Hyup Kim; Kyung Mo Yeon; Il Soo Ha; Hae Il Cheong; Yong Choi Journal: Pediatr Radiol Date: 2006-04-26
Authors: Jae Il Shin; Jee Min Park; Soon Min Lee; Youn Ho Shin; Ji Hong Kim; Jae Seung Lee; Myung Joon Kim Journal: Pediatr Nephrol Date: 2005-03-17 Impact factor: 3.714