Nutcracker syndrome complicated with intestinal malrotation

BMJ Case Rep. 2019 Oct 10;12(10):e231230. doi: 10.1136/bcr-2019-231230.

Abstract

Nutcracker syndrome (NCS) is a pathological condition in which the left renal vein (LRV) is compressed between the superior mesenteric artery (SMA) and aorta. NCS can predispose patients to the onset of chronic kidney disease because of persistent increase in LRV pressure. Although NCS in children is often idiopathic, it can also be caused by underlying pathologies such as retroperitoneal tumours. To the best of our knowledge, there have been no reports regarding paediatric cases of NCS complicated with intestinal malrotation. Here, we report the case of a 12-year-old girl with intestinal malrotation complicated with NCS whose haematuria resolved after surgical intervention for intestinal malrotation. The present case findings indicate that intestinal malrotation with concomitant weight loss is a potential underlying aetiology in NCS. Thus, when NCS is especially diagnosed with gastrointestinal symptoms, intestinal malrotation should be considered as an underlying aetiology.

Keywords: gastrointestinal surgery; haematuria; paediatrics.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain
  • Child
  • Digestive System Abnormalities / complications*
  • Digestive System Abnormalities / diagnostic imaging
  • Digestive System Abnormalities / surgery
  • Female
  • Hematuria
  • Humans
  • Intestinal Volvulus / complications*
  • Intestinal Volvulus / diagnostic imaging
  • Intestinal Volvulus / surgery
  • Laparoscopes
  • Renal Nutcracker Syndrome / diagnostic imaging
  • Renal Nutcracker Syndrome / etiology*
  • Tomography, X-Ray Computed
  • Vomiting

Supplementary concepts

  • Volvulus Of Midgut