RESUMEN
Nutcracker syndrome (NCS) refers to left renal vein compression with impaired blood outflow. The etiology of NCS has been attributed to various anatomic anomalies. Posterior NCS is caused by compression of the retroaortic left renal vein between the aorta and spine. The classic symptoms of NCS include left flank pain with gross or microscopic hematuria. The frequency and severity of the syndrome vary from asymptomatic microhematuria to severe pelvic congestion. For this reason, diagnosis of NCS is difficult and often delayed. Here, we report a case of posterior NCS that was incidentally discovered.
Asunto(s)
Aorta , Diagnóstico , Estrógenos Conjugados (USP) , Dolor en el Flanco , Hematuria , Venas Renales , Columna VertebralRESUMEN
La vena renal izquierda (VRI) presenta diversas variantes en su desarrollo; las dos más frecuentes son la circumaórtica y la retroaórtica. El síndrome del cascanueces anterior es la compresión de la VRI entre la aorta y la arteria mesentérica superior, mientras que el síndrome del cascanueces posterior se produce entre la columna vertebral y la aorta. Derivaron a un varón adolescente (16 años de edad) a la sala de emergencias debido a dolor en una de las fosas renales. En la tomografía computada se halló la combinación de síndrome del cascanueces anterior y posterior en la vena renal izquierda circumaórtica, circunstancia nunca antes descrita en un adolescente.
The left renal vein (LRV) has many developmental variations; the two most common are the circumaortic and the retrocaval. Anterior nutcracker syndrome is the compression of the LRV between the aorta and superior mesenteric artery, whereas posterior nutcracker syndrome occurs between the vertebral column and the aorta. An adolescent male (aged 16 years) was referred to the emergency department for flank pain. CT findings showed the combination of anterior and posterior nutcracker syndrome in the left circumaortic renal vein, which has not previously been described in an adolescent.