Nutcracker syndrome due to chronic aortic dissection

J Card Surg. 2021 Mar;36(3):1138-1139. doi: 10.1111/jocs.15400. Epub 2021 Feb 1.

Abstract

Nutcracker syndrome (NCS) is known as a status of compression of the left renal vein (LRV) between the abdominal aorta and superior mesenteric artery (SMA). We here report a case of NCS in a Marfan syndrome patient with type B aortic dissection who was presented with sudden gross hematuria. Computed tomography revealed the compression of the LRV sandwiched between the SMA and the dilated dissecting abdominal aorta. The compression was released by surgical intervention and the hematuria was promptly resolved. This report highlights that NCS should be considered as a differential diagnosis of unexplained hematuria in patients with a chronic dissecting aorta.

Keywords: aortic dissection; graft replacement of the thoracoabdominal aorta; hematuria; nutcracker syndrome.

Publication types

  • Case Reports

MeSH terms

  • Aorta, Abdominal / diagnostic imaging
  • Aorta, Abdominal / surgery
  • Aortic Dissection* / complications
  • Aortic Dissection* / diagnostic imaging
  • Aortic Dissection* / surgery
  • Hematuria / etiology
  • Humans
  • Mesenteric Artery, Superior
  • Renal Veins*