The Nutcracker Syndrome.

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This case report describes a 43-year-old asymptomatic female with incidentally discovered hematuria during an annual check-up. Initial physical examinations and abdominal ultrasonography were inconclusive, prompting further investigation via contrast-enhanced computed tomography. The imaging results identified Nutcracker Syndrome, characterized by compression of the left renal vein between the abdominal aorta and superior mesenteric artery. The authors note that this rare condition should be considered in cases of unexplained hematuria after other diagnoses are excluded. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

Nutcracker syndrome (NCS) is a rare condition caused by the compression of the left renal vein between the abdominal aorta and the superior mesenteric artery. NCS may present with unexplained hematuria. This case report presents a 43-year-old healthy female without any complaints who had newly-detected hematuria in urinalysis during her annual examination. Her physical examination and the whole abdominal ultrasonography failed to explain the cause of hematuria. Further investigation with contrast-enhanced upper abdominal computed tomography revealed a NCS. In unexplained cases of asymptomatic hematuria NCS should be taken into account after excluding other preliminary diagnoses.
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The Nutcracker Syndrome DOI: https://doi.org/10.3941/jrcr.v16i5.4339Keywords: Nutcracker syndrome, rare disease, hematuria, left renal vein compression, renal vein entrapmentAbstract Nutcracker syndrome (NCS) is a rare condition caused by the compression of the left renal vein between the abdominal aorta and the superior mesenteric artery. NCS may present with unexplained hematuria. This case report presents a 43-year-old healthy female without any complaints who had newly-detected hematuria in urinalysis during her annual examination. Her physical examination and the whole abdominal ultrasonography failed to explain the cause of hematuria. Further investigation with contrast-enhanced upper abdominal computed tomography revealed a NCS. In unexplained cases of asymptomatic hematuria NCS should be taken into account after excluding other preliminary diagnoses.Downloads Published 2022-05-31 Issue Section General Radiology License The publisher holds the copyright to the published articles and contents. However, the articles in this journal are open-access articles distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License, which permits reproduction and distribution, provided the original work is properly cited. The publisher and author have the right to use the text, images and other multimedia contents from the submitted work for further usage in affiliated programs. Commercial use and derivative works are not permitted, unless explicitly allowed by the publisher.

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