Nutcracker Syndrome as an Unusual Cause of Postprandial Pain
Nutcracker syndrome is a rare entity in which compression of the left renal vein (LRV), usually by the overlying superior mesenteric artery (SMA), results in renal venous congestion and reflux in the left ovarian vein (LOV). Patients may present with hematuria, left flank pain, dyspareunia, and vagi...
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| Veröffentlicht in: | Vascular and endovascular surgery 2020-04, Vol.54 (3), p.283-285 |
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| container_title | Vascular and endovascular surgery |
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| creator | Maloni, Krystal C. Calligaro, Keith D. Lipshutz, William Vani, Kunal Troutman, Douglas A. Dougherty, Matthew J. |
| description | Nutcracker syndrome is a rare entity in which compression of the left renal vein (LRV), usually by the overlying superior mesenteric artery (SMA), results in renal venous congestion and reflux in the left ovarian vein (LOV). Patients may present with hematuria, left flank pain, dyspareunia, and vaginal or abdominal wall varicose veins. We report a patient with nutcracker syndrome who presented atypically with left flank pain that was exacerbated in the postprandial state. We hypothesize that the physiologic dilation of the SMA after oral intake caused increased LRV compression at that site and augmented lateral LRV distention. The patient had no evidence of SMA syndrome or chronic mesenteric insufficiency. Her symptoms resolved after we performed an LOV to inferior vena cava transposition. |
| doi_str_mv | 10.1177/1538574419896721 |
| format | Article |
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Patients may present with hematuria, left flank pain, dyspareunia, and vaginal or abdominal wall varicose veins. We report a patient with nutcracker syndrome who presented atypically with left flank pain that was exacerbated in the postprandial state. We hypothesize that the physiologic dilation of the SMA after oral intake caused increased LRV compression at that site and augmented lateral LRV distention. The patient had no evidence of SMA syndrome or chronic mesenteric insufficiency. Her symptoms resolved after we performed an LOV to inferior vena cava transposition.</description><identifier>ISSN: 1538-5744</identifier><identifier>EISSN: 1938-9116</identifier><identifier>DOI: 10.1177/1538574419896721</identifier><identifier>PMID: 31884879</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Female ; Flank Pain - diagnosis ; Flank Pain - etiology ; Humans ; Mesenteric Artery, Superior - diagnostic imaging ; Mesenteric Artery, Superior - physiopathology ; Middle Aged ; Ovary - blood supply ; Postprandial Period ; Renal Nutcracker Syndrome - complications ; Renal Nutcracker Syndrome - diagnostic imaging ; Renal Nutcracker Syndrome - surgery ; Renal Veins - diagnostic imaging ; Renal Veins - physiopathology ; Treatment Outcome ; Vascular Grafting - methods ; Vasodilation ; Vena Cava, Inferior - surgery</subject><ispartof>Vascular and endovascular surgery, 2020-04, Vol.54 (3), p.283-285</ispartof><rights>The Author(s) 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c304t-aee90fef44cadda8565fa9d33ece282cf31912fbb5ef0c2bfdf49c1c5bebe54a3</citedby><cites>FETCH-LOGICAL-c304t-aee90fef44cadda8565fa9d33ece282cf31912fbb5ef0c2bfdf49c1c5bebe54a3</cites><orcidid>0000-0003-2122-9560</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1538574419896721$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1538574419896721$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31884879$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maloni, Krystal C.</creatorcontrib><creatorcontrib>Calligaro, Keith D.</creatorcontrib><creatorcontrib>Lipshutz, William</creatorcontrib><creatorcontrib>Vani, Kunal</creatorcontrib><creatorcontrib>Troutman, Douglas A.</creatorcontrib><creatorcontrib>Dougherty, Matthew J.</creatorcontrib><title>Nutcracker Syndrome as an Unusual Cause of Postprandial Pain</title><title>Vascular and endovascular surgery</title><addtitle>Vasc Endovascular Surg</addtitle><description>Nutcracker syndrome is a rare entity in which compression of the left renal vein (LRV), usually by the overlying superior mesenteric artery (SMA), results in renal venous congestion and reflux in the left ovarian vein (LOV). Patients may present with hematuria, left flank pain, dyspareunia, and vaginal or abdominal wall varicose veins. We report a patient with nutcracker syndrome who presented atypically with left flank pain that was exacerbated in the postprandial state. We hypothesize that the physiologic dilation of the SMA after oral intake caused increased LRV compression at that site and augmented lateral LRV distention. The patient had no evidence of SMA syndrome or chronic mesenteric insufficiency. Her symptoms resolved after we performed an LOV to inferior vena cava transposition.</description><subject>Female</subject><subject>Flank Pain - diagnosis</subject><subject>Flank Pain - etiology</subject><subject>Humans</subject><subject>Mesenteric Artery, Superior - diagnostic imaging</subject><subject>Mesenteric Artery, Superior - physiopathology</subject><subject>Middle Aged</subject><subject>Ovary - blood supply</subject><subject>Postprandial Period</subject><subject>Renal Nutcracker Syndrome - complications</subject><subject>Renal Nutcracker Syndrome - diagnostic imaging</subject><subject>Renal Nutcracker Syndrome - surgery</subject><subject>Renal Veins - diagnostic imaging</subject><subject>Renal Veins - physiopathology</subject><subject>Treatment Outcome</subject><subject>Vascular Grafting - methods</subject><subject>Vasodilation</subject><subject>Vena Cava, Inferior - surgery</subject><issn>1538-5744</issn><issn>1938-9116</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1UE1LAzEQDaLYWr17kvyB1cwm6SbgRRa_oGhBe15mk4m0trtL0j3037ul6kHwNI95H_AeY5cgrgGK4ga0NLpQCqyx0yKHIzYGK01mAabHAx7obM-P2FlKKyHAgDKnbCTBGGUKO2a3L_3WRXSfFPnbrvGx3RDHxLHhi6ZPPa55iX0i3gY-b9O2i9j45fCd47I5ZycB14kuvu-ELR7u38unbPb6-FzezTInhdpmSGRFoKCUQ-_R6KkOaL2U5Cg3uQsSLOShrjUF4fI6-KCsA6drqkkrlBMmDrkutilFClUXlxuMuwpEtR-i-jvEYLk6WLq-3pD_Nfw0HwTZQZDwg6pV28dmqPB_4BcMj2b0</recordid><startdate>202004</startdate><enddate>202004</enddate><creator>Maloni, Krystal C.</creator><creator>Calligaro, Keith D.</creator><creator>Lipshutz, William</creator><creator>Vani, Kunal</creator><creator>Troutman, Douglas A.</creator><creator>Dougherty, Matthew J.</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><orcidid>https://orcid.org/0000-0003-2122-9560</orcidid></search><sort><creationdate>202004</creationdate><title>Nutcracker Syndrome as an Unusual Cause of Postprandial Pain</title><author>Maloni, Krystal C. ; Calligaro, Keith D. ; Lipshutz, William ; Vani, Kunal ; Troutman, Douglas A. ; Dougherty, Matthew J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c304t-aee90fef44cadda8565fa9d33ece282cf31912fbb5ef0c2bfdf49c1c5bebe54a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Female</topic><topic>Flank Pain - diagnosis</topic><topic>Flank Pain - etiology</topic><topic>Humans</topic><topic>Mesenteric Artery, Superior - diagnostic imaging</topic><topic>Mesenteric Artery, Superior - physiopathology</topic><topic>Middle Aged</topic><topic>Ovary - blood supply</topic><topic>Postprandial Period</topic><topic>Renal Nutcracker Syndrome - complications</topic><topic>Renal Nutcracker Syndrome - diagnostic imaging</topic><topic>Renal Nutcracker Syndrome - surgery</topic><topic>Renal Veins - diagnostic imaging</topic><topic>Renal Veins - physiopathology</topic><topic>Treatment Outcome</topic><topic>Vascular Grafting - methods</topic><topic>Vasodilation</topic><topic>Vena Cava, Inferior - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Maloni, Krystal C.</creatorcontrib><creatorcontrib>Calligaro, Keith D.</creatorcontrib><creatorcontrib>Lipshutz, William</creatorcontrib><creatorcontrib>Vani, Kunal</creatorcontrib><creatorcontrib>Troutman, Douglas A.</creatorcontrib><creatorcontrib>Dougherty, Matthew J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Vascular and endovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maloni, Krystal C.</au><au>Calligaro, Keith D.</au><au>Lipshutz, William</au><au>Vani, Kunal</au><au>Troutman, Douglas A.</au><au>Dougherty, Matthew J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nutcracker Syndrome as an Unusual Cause of Postprandial Pain</atitle><jtitle>Vascular and endovascular surgery</jtitle><addtitle>Vasc Endovascular Surg</addtitle><date>2020-04</date><risdate>2020</risdate><volume>54</volume><issue>3</issue><spage>283</spage><epage>285</epage><pages>283-285</pages><issn>1538-5744</issn><eissn>1938-9116</eissn><abstract>Nutcracker syndrome is a rare entity in which compression of the left renal vein (LRV), usually by the overlying superior mesenteric artery (SMA), results in renal venous congestion and reflux in the left ovarian vein (LOV). Patients may present with hematuria, left flank pain, dyspareunia, and vaginal or abdominal wall varicose veins. We report a patient with nutcracker syndrome who presented atypically with left flank pain that was exacerbated in the postprandial state. We hypothesize that the physiologic dilation of the SMA after oral intake caused increased LRV compression at that site and augmented lateral LRV distention. The patient had no evidence of SMA syndrome or chronic mesenteric insufficiency. Her symptoms resolved after we performed an LOV to inferior vena cava transposition.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>31884879</pmid><doi>10.1177/1538574419896721</doi><tpages>3</tpages><orcidid>https://orcid.org/0000-0003-2122-9560</orcidid></addata></record> |
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| ispartof | Vascular and endovascular surgery, 2020-04, Vol.54 (3), p.283-285 |
| issn | 1538-5744 1938-9116 |
| language | eng |
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| source | MEDLINE; SAGE Complete; Alma/SFX Local Collection |
| subjects | Female Flank Pain - diagnosis Flank Pain - etiology Humans Mesenteric Artery, Superior - diagnostic imaging Mesenteric Artery, Superior - physiopathology Middle Aged Ovary - blood supply Postprandial Period Renal Nutcracker Syndrome - complications Renal Nutcracker Syndrome - diagnostic imaging Renal Nutcracker Syndrome - surgery Renal Veins - diagnostic imaging Renal Veins - physiopathology Treatment Outcome Vascular Grafting - methods Vasodilation Vena Cava, Inferior - surgery |
| title | Nutcracker Syndrome as an Unusual Cause of Postprandial Pain |
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