Nutcracker syndrome: A rare cause of left flank pain that can also manifest as unexplained pelvic pain.

摘要: Nutcracker syndrome (NCS) is symptomatic unilateral renal venous hypertension due to compression of the left vein between superior mesenteric artery and aorta (anterior NCS) or spine (posterior NCS). The ovarian spermatic empties into an additional site venostasis in about half cases NCS. presenting symptom NCS atypical flank pain suggesting a disorder lower ribs thoracolumbar spinal junction, particularly as worsens with standing increased lumbar lordosis. may be suggested by any combination following manifestations: hematuria, which often only microscopic; orthostatic proteinuria; varicocele infertility; dyspareunia other gynecological symptoms; varicose veins pelvis, buttocks, upper thighs; hypotension fatigue; abdominal pain. Narrowing on imaging studies required but far from sufficient establish diagnosis. Several converging clinical findings marked pressure gradient inferior vena cava must present also. Urological procedures vascular surgery are being superseded endovascular stenting without simultaneous treatment acquired gonadal insufficiency embolization.