[Nutcracker syndrome. Hematuria without diagnosis?]. 2011

Rita Calado, and Mónica Braz, and Luísa Lobo, and Carla Simão
Serviço de Pediatria, Hospital Espírito Santo, Évora, Portugal.

The nutcracker syndrome is associated with left renal vein compression in its passage between the abdominal aorta and superior mesenteric artery. This phenomenon can cause left renal vein hypertension manifested by abdominal pain, hematuria, and pelvic congestion syndrome. The diagnosis is essentially clinical, supported by imaging and necessarily one of exclusion. The literature suggests that it occurs with a reasonable prevalence in children who present with isolated hematuria but is commonly misdiagnosed. We describe two clinical cases of children with hematuria whose investigation led to the diagnosis of Nutcracker Syndrome. In the presence of hematuria of unknown origin it's necessary to consider this entity, highlighting the essential role of a noninvasive test such as renal ultrasound with Doppler in its diagnosis.

UI MeSH Term Description Entries
D008297 Male Males
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D006417 Hematuria Presence of blood in the urine. Hematurias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014463 Ultrasonography The visualization of deep structures of the body by recording the reflections or echoes of ultrasonic pulses directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. Echography,Echotomography,Echotomography, Computer,Sonography, Medical,Tomography, Ultrasonic,Ultrasonic Diagnosis,Ultrasonic Imaging,Ultrasonographic Imaging,Computer Echotomography,Diagnosis, Ultrasonic,Diagnostic Ultrasound,Ultrasonic Tomography,Ultrasound Imaging,Diagnoses, Ultrasonic,Diagnostic Ultrasounds,Imaging, Ultrasonic,Imaging, Ultrasonographic,Imaging, Ultrasound,Imagings, Ultrasonographic,Imagings, Ultrasound,Medical Sonography,Ultrasonic Diagnoses,Ultrasonographic Imagings,Ultrasound, Diagnostic,Ultrasounds, Diagnostic
D059228 Renal Nutcracker Syndrome Left RENAL VEIN compression between the AORTA, ABDOMINAL and the SUPERIOR MESENTERIC ARTERY. Variable symptoms include HYPERTENSION, RENOVASCULAR; HEMATURIA; and VARICOSE VEINS. Renal Nutcracker Phenomenon,Renal Vein Entrapment Syndrome,Nutcracker Phenomenon, Renal,Nutcracker Phenomenons, Renal,Nutcracker Syndrome, Renal,Nutcracker Syndromes, Renal,Phenomenon, Renal Nutcracker,Phenomenons, Renal Nutcracker,Renal Nutcracker Phenomenons,Renal Nutcracker Syndromes

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