Nutcracker syndrome

The nutcracker syndrome is caused by pinching (impingement ) of the left renal vein between the superior mesenteric artery and the abdominal aorta.

Symptoms

Often there are no symptoms. However, it rarely leads to a venous outflow obstruction of Eierstockvene ( ovarian vein ), Hodenvene ( varicocele ) and the formation of varicose veins of the pelvis. In urine, blood can ( hematuria) and protein (proteinuria ) be detectable, especially in the upright posture ( orthostatic proteinuria). Occasionally, pain in the abdomen or the left flank.

In men, as a result of varicocele pain in the testicles and disorders of sperm production (spermatogenesis ) may occur. In women, the varicose veins in the pelvis can to pressure pain in the region of the ovaries ( ovaries ) and pain during intercourse ( dyspareunia ) lead.

Diagnostics

Search methods are Doppler sonography, computed tomography, magnetic resonance imaging. The confirmation of the diagnosis is made by contrast agent representation of the renal vein ( venography ) and pressure measurements in renal vein and inferior vena cava.

Therapy

Surgical treatment methods are removal of the left kidney ( nephrectomy ), surgical fixation of the kidney ( nephropexy ), surgical diversion of the renal vein or transplantation of the left kidney in the pelvis ( autograft ). Alternatively, can be introduced via a catheter procedure, a stent in the left renal vein to keep it open.

Swell

Antonio Granata et al.: Quiz Page August 2007 In: . American journal of kidney diseases. No. 50, 2007, pp. A43 - A44 ( article).

• Disease in nephrology
• Disease in urology
• Disease in gynecology and obstetrics