scholarly journals Retroperitoneal Lipoma Presenting with Nutcracker-Like Phenomenon

2013 ◽  
Vol 2013 ◽  
pp. 1-2 ◽  
Author(s):  
Seiichi Saito
Keyword(s):  
Computed Tomography ◽  
Renal Artery ◽  
Renal Vein ◽  
Left Renal Vein ◽  
Flank Pain ◽  
Left Renal Artery ◽  
Left Flank ◽  
Left Flank Pain

Retroperitoneal lipoma presenting with a nutcracker-like phenomenon is extremely rare. I experienced a case of a 65-year-old man presenting with left flank pain and macrohematuria intermittently for 3 years. Computed tomography revealed a lipoma at the left pedicle of the kidney, 30 mm in diameter, causing a curving of the left renal artery and dilatation of the left renal vein. This patient was treated successfully by retroperitoneoscopic resection of the lipoma. There have been no symptoms for 10 years after the operation.

scholarly journals A rare presentation of nutcracker syndrome and it’s vascular managment

2017 ◽  
Vol 7 (1) ◽  
pp. 13
Author(s):  
Nguessan Judicael Ahoury ◽  
Salami Fatima Adéniké ◽  
Ndja Ange Patrick ◽  
Cavez Nicolas ◽  
Kouassi Paul Nzi
Keyword(s):  
Renal Vein ◽  
Mesenteric Artery ◽  
Left Renal Vein ◽  
Flank Pain ◽  
Nutcracker Syndrome ◽  
Rare Presentation ◽  
Left Flank ◽  
Long Time ◽  
Angio Ct ◽  
Left Flank Pain

Nutcracker syndrome includes all the symptoms associated with the narrowing of the left renal vein (LRV). That narrowing occurs between the aorta and the Superior Mesenteric Artery (anterior) or vertebra (posterior). The symptoms are various and not specific but the patient sometimes presents hematuria with or without left flank pain. We report a case on a 42 years old woman, who was suffering from left flank pain for a long time aggravated during and after each pregnancy. The diagnosis of nutcracker syndrome was initially omitted. Abdominal pelvic Angio CT and venography were performed. We placed a percutaneous stent in the narrowed portion of the renal vein. The result was successful.

scholarly journals Vanishing splenic cyst- visible on ultrasound but non-detected on MRI

2019 ◽  
Vol 28 (3) ◽  
pp. 262-262
Author(s):  
Cosmin Caraiani ◽  
Timothy Kurniawan ◽  
Renata Vasilache ◽  
Ciprian Brisc
Keyword(s):  
Gastric Emptying ◽  
Renal Vein ◽  
Mesenteric Artery ◽  
Delayed Gastric Emptying ◽  
Left Renal Vein ◽  
Flank Pain ◽  
Splenic Cyst ◽  
Compression Syndrome ◽  
Left Flank ◽  
Left Flank Pain

This paper ilustrates the imaging aspect of a rare pathology- aorto-mesenteric compression syndrome (Wilkie's disease). In this disease acute angulation of the superior mesenteric artery will lead to compression of the duodenum and of the left renal vein. Duodenal compression may lead to delayed gastric emptying and to nutcraker syndrome when left flank pain and hematuria may be present

scholarly journals Nutcracker Syndrome in Children: Role of Doppler Ultrasonographic Indices in Detecting the Pattern of Symptoms

2018 ◽  
Vol 7 (8) ◽  
pp. 214 ◽  
Author(s):  
Hulya Nalcacioglu ◽  
Meltem Ceyhan Bilgici ◽  
Demet Tekcan ◽  
Gurkan Genc ◽  
Yakup Bostanci ◽  
...  
Keyword(s):  
Renal Vein ◽  
Pediatric Patients ◽  
Left Renal Vein ◽  
Flank Pain ◽  
Nutcracker Syndrome ◽  
Macroscopic Hematuria ◽  
Presenting Symptoms ◽  
Left Flank ◽  
The Mean ◽  
Left Flank Pain

The purpose of this study was to evaluate the clinical characteristics of 44 pediatric patients who were diagnosed as having nutcracker syndrome (NCS). We also investigated the left renal vein Doppler ultrasonography (DUS) results, to determine whether or not there was an association between clinical symptoms and DUS findings among these patients. The clinical data from 44 pediatric patients who were diagnosed as having NCS from January 2008 to December 2015 were retrospectively reviewed. We grouped the patients according to the presenting symptoms as symptomatic (loin pain; macroscopic hematuria or both) and non-symptomatic (microscopic hematuria and proteinuria were detected incidentally) and evaluated the left renal vein DUS indices in these two groups separately. Asymptomatic NCS was found in 27 (61.4%) patients; 21 (47.7%) of whom were admitted for the evaluation of proteinuria. The most frequent presenting symptoms were left flank pain (20.5%) and macroscopic hematuria (13.6%); and 2 (4.5%) patients presented with a combination of left flank pain and macroscopic hematuria. The mean ratio of the diameter of the hilar portion of the left renal vein (LRV) to that of the aortomesenteric portion was 4.36 ± 1.55. The mean ratio of the peak velocity (PV) between the two sites of the LRV was 7.32 ± 2.68 (3.1–15.6). The differences in the ratio of the diameters were statistically significant between the two groups and significantly higher in children with asymptomatic NCS (p = 0.025). The PV ratios of the LRV (p = 0.035) were significantly higher in asymptomatic children with NCS than in the symptomatic group. Our study identifies that increased compression ratio of the LRV entrapment is most observed in orthostatic proteinuria and microscopic hematuria.

scholarly journals Nutcracker Syndrome Complicated by Left Renal Vein Thrombosis

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Faouzi Mallat ◽  
Wissem Hmida ◽  
Mehdi Jaidane ◽  
Nadia Mama ◽  
Faouzi Mosbah
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Renal Vein ◽  
Left Renal Vein ◽  
Renal Vein Thrombosis ◽  
Flank Pain ◽  
Complete Disappearance ◽  
Nutcracker Syndrome ◽  
Rare Entity ◽  
Vein Thrombosis

Isolated renal vein thrombosis is a rare entity. We present a patient whose complaint of flank pain led to the diagnosis of a renal vein thrombosis. In this case, abdominal computed tomography angiography was helpful in diagnosing the nutcracker syndrome complicated by the renal vein thrombosis. Anticoagulation was started and three weeks later, CTA showed complete disappearance of the renal vein thrombosis. To treat the Nutcracker syndrome, we proposed left renal vein transposition that the patient consented to.

scholarly journals Left flank pain during pregnancy with an unpredictable etiology: think of nonhemorrhagic adrenal infarction

2021 ◽  
pp. FSO718
Author(s):  
Myriam Jerbaka ◽  
Tracy Slaiby ◽  
Zahraa Farhat ◽  
Yara Diab ◽  
Nawal Toufayli ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Pregnant Woman ◽  
Pregnant Patient ◽  
Flank Pain ◽  
Computed Tomography Scan ◽  
Left Flank ◽  
Left Flank Pain ◽  
Tomography Scan ◽  
Adrenal Infarction

Abdominal pain is the most presenting complaint during pregnancy with multiple etiologies. The diagnosis could be unpredictable. We present a case of 36-year-old pregnant woman gravida 10 para 7 abortus 2 at 36 + 5 weeks of gestation presenting twice for an increasing left abdominal pain, not relieved despite analgesics. She was delivered for severe oligohydramnios. After delivery, she was found to have a left adrenal infarction on computed tomography scan. She was found to have two mutations of the gene  MTHFR 677CC. Our presented case should remind physicians to consider the presence of thromboembolic state during pregnancy. The diagnosis of adrenal infarction should be among the differentials of an ambiguous flank pain that is resilient to medical therapy. Diagnosis in a pregnant patient can be easily confirmed with MRI, after which anticoagulation should be started and the workup for hypercoagulable state investigated.

Anterior Nutcracker Syndrome with Left Gonadal Vein Varicosities on Multiphasic Computed Tomography: An Unexpected Cause of Pyeloureteral Junction Obstruction

2015 ◽  
Vol 97 (4) ◽  
pp. 482-484
Author(s):  
Maddalena Di Carlo ◽  
Caterina Gaudiano ◽  
Fiorenza Busato ◽  
Simone Pucci ◽  
Riccardo Schiavina ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Renal Vein ◽  
Mesenteric Artery ◽  
Left Renal Vein ◽  
Nutcracker Syndrome ◽  
Left Flank ◽  
Gonadal Vein ◽  
Renal Hilum ◽  
Left Flank Pain ◽  
Uncommon Complication

The anterior nutcracker syndrome is defined by the compression of the left renal vein between the aorta and superior mesenteric artery, usually related to the occurrence of hematuria. We report the case of an uncommon complication of the nutcracker syndrome. A 75-year-old woman was referred to our institution for left flank pain without hematuria. Multiphasic computer tomography urography showed a condition of left renal vein entrapment between the aorta and superior mesenteric artery with the development of left gonadal vein varicosities at the level of the renal hilum; a pyeloureteral junction compression with dilation of the pyelocalyceal system coexisted. To our knowledge, this is the first report of the association between nutcracker syndrome and pyeloureteral junction obstruction.

scholarly journals SURGICAL TREATMENT OF CHILDREN WITH NEUROBLASTOMA OF COMPLEX ANATOMICAL LOCALIZATION

2018 ◽  
Vol 22 (4) ◽  
pp. 172-178
Author(s):  
M. N. Sukhov ◽  
Sergey V. Sokolov ◽  
A. G. Narbutov ◽  
I. P. Lyvina ◽  
E. S. Andreev ◽  
...  
Keyword(s):  
Renal Artery ◽  
Renal Vein ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Celiac Trunk ◽  
Left Renal Artery ◽  
Internal Organs ◽  
The Right ◽  
Large Vessels

Introduction. Neuroblastomas arise in the case of intimate association of the tumor with large vessels and internal organs. The early detailed stratification of cancer risk, as well as forecasting possible complications of surgery based on visual diagnostic methods, contribute to the improving the results in this category of patients. Material and methods. The study analyzes the results of the diagnosis and treatment of neuroblastoma of thoracoabdominal localization in 9 children aged from 9 to 55 months. All of them received the treatment according to the NB-2004 protocol. Before surgical intervention, the factors of the surgical risk were estimated from computed tomography with contrast, the number of factors averaged of 5. Results. The inclusion of the left renal artery and aorta into the tumor was revealed intraoperatively in 8 children, the involvement of the left renal vein, the right renal artery, the superior mesenteric artery was found in 7 patients, the right renal vein, the celiac trunk - in 6 cases, and the other large vessels - in a smaller number of cases. Damages of the right renal vein in 2 patients, left renal vein - in 2 children, aorta - in 1 child, inferior vena cava - in 2 observations and celiac trunk in 1 patient was sutured without subsequent complications. After injury and suturing of the inferior vena cava in a 1 patient, there was revealed a parietal thrombus without clinically significant hemodynamic disturbances. In 1 observation, postoperative thrombosis of the left renal artery caused the deterioration of the blood flow requiring nephrectomy. Damage to the pancreas in 1 child was accompanied by a long drainage and the formation of pancreatojejunostomy. The volume of the resection of the tumor amounted on average of 93%. The total number of complications in the early postoperative period accounted for 44%, out of which repeated surgical interventions were required in case of bleeding against the therapy of renal artery thrombosis in 1 patient and focal pancreatic necrosis in the 1 patient. The duration of postoperative follow-up was of 18 months. Overall survival is 100%, the event-free survival rate is of 78%. The continued growth of the tumor was registered in 2 patients in the high-risk group. Discussion. Neoadjuvant chemotherapy contributed to the enhancement of the radicalization of the surgical treatment, leading to a decrease in the size of the primary focus, metastases, and involvement of large vessels and internal organs in the tumor. The radical removal of neuroblastoma is acceptable in the absence of the invasive growth in the walls of large vessels and internal organs, otherwise, the resection should be performed for the purpose of cytoreduction and prevention of organ failure due to tumor compression.

Variations in the anatomic relationship of the left renal vein to the left renal artery at the aorta

1990 ◽  
Vol 3 (4) ◽  
pp. 249-255 ◽  
Author(s):  
R. James Valentine ◽  
Dougald C. MacGillivray ◽  
Charles L. Blankenship ◽  
Gary G. Wind
Keyword(s):  
Renal Artery ◽  
Renal Vein ◽  
Left Renal Vein ◽  
Left Renal Artery ◽  
Relationship Of ◽  
Anatomic Relationship

Normal left renal vein mimicking left renal artery aneurysm

1981 ◽  
Vol 9 (3) ◽  
pp. 105-108 ◽  
Author(s):  
Alfred B. Kurtz ◽  
Paul A. Dubbins ◽  
Harry G. Zegel ◽  
Catherine Cole-Beuglet ◽  
Barry B. Goldberg
Keyword(s):  
Renal Artery ◽  
Renal Vein ◽  
Left Renal Vein ◽  
Artery Aneurysm ◽  
Left Renal Artery ◽  
Renal Artery Aneurysm

Cyclosporin and quinidine inhibition of renal digoxin excretion: evidence for luminal secretion of digoxin

1992 ◽  
Vol 263 (4) ◽  
pp. F613-F622 ◽  
Author(s):  
I. A. De Lannoy ◽  
G. Koren ◽  
J. Klein ◽  
J. Charuk ◽  
M. Silverman
Keyword(s):  
Renal Artery ◽  
Renal Vein ◽  
Left Renal Vein ◽  
Basolateral Membrane ◽  
Resistant Cell Line ◽  
Dilution Method ◽  
Left Renal Artery ◽  
Recovery Ratio ◽  
Dependent Manner

We studied the in vivo luminal and contraluminal uptake of [3H]digoxin in dog kidney using the single-pass multiple indicator dilution method. A bolus tracer of 125I-albumin (plasma reference), creatinine, or L-[14C]glucose [extracellular reference (ecf)] and [3H]digoxin (or [3H]ouabain) was injected into the left renal artery, and timed serial samples were collected from the left renal vein (basolateral uptake) and left and right ureters (luminal uptake). [3H]ouabain was excreted solely by filtration and exhibited saturable and irreversible binding at the basolateral surface. Uptake of [3H]digoxin across the basolateral membrane was large and nonsaturable. Despite urine flow-dependent reabsorption and approximately 20% protein binding, the urine recovery ratio for [3H]-digoxin/glomerular (ecf) marker was 0.97 +/- 0.04 (n = 29), indicating net digoxin secretion. After intravenous infusions of cyclosporin in Cremophor EL (0.5-3.5 microM), the urine recovery ratio decreased in a dose-dependent manner from control values of 1.13 +/- 0.06 (n = 12) to 0.62 +/- 0.03 (n = 14). There was no change in the relative renal vein recovery. Left renal artery infusion of quinidine (37.5 micrograms.min-1.kg-1) decreased the relative urine recovery of [3H]digoxin by 46% (n = 6) but had no effect on postglomerular extraction. Cyclosporin and quinidine are known inhibitors of P-glycoprotein. But digoxin did not compete with [3H]azidopine for binding in rat brush-border membranes or membranes prepared from the multidrug-resistant cell line CHRC5. The exact mechanism for renal digoxin secretion remains to be determined, but our results point to a luminal localization of this secretory system.

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