ArticleJournal of medical case reports2021
Posterior nutcracker syndrome: a case report.
Article in Journal of medical case reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 12 citations in OpenAlex.
- Percutaneous left renal vein stenting in posterior nutcracker syndrome: technical and antithrombotic nuances - a case report.Frontiers in cardiovascular medicine · 2026Article
- A Cadaveric Case Report of Retroaortic Left Renal Vein in an Elderly Male With Multiple Known Comorbidities.Cureus · 2024Article
- Double nutcracker syndrome in a patient with circumaortic venous ring: a rare case report.Journal of ultrasonography · 2023Article
- Ultrasound features of posterior nutcracker syndrome: case series and literature analysis.Quantitative imaging in medicine and surgery · 2022Article
- Article
- Vascular compression syndromes: a pictorial review.Ultrasonography (Seoul, Korea) · 2022Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPosterior nutcracker syndrome is defined by the compression of the left renal vein between the abdominal aorta and a lumbar vertebral body. It can be clinically manifest with intermittent hematuria, gonadal or spermatic reflux resulting in varicocele. Ultrasound is the first-line imaging which require more accurate study with contrast-enhanced computed tomography. Management can be conservative in younger patients with mild hematuria due to the high spontaneous remission rate and invasive with open surgical and endovascular interventions. We describe a very rare case with compression of the left renal vein due to an osteophyte of the spine. CASE PRESENTATION: A 62-year-old Caucasic male came to our radiology department for chronic hepatitis B virus (HBV)-related liver disease follow-up and mild scrotal pain. The ultrasound examination revealed a compression of the left retro-aortic renal vein in the aorto-vertebral space caused by an osteophyte. Duplex Doppler ultrasound revealed flow congestion in the left renal vein and renal failure; power Doppler ultrasound showed left varicocele.
conclusionsDoppler ultrasound is the first-line imaging and allows the detection of all the typical signs of posterior nutcracker: left renal vein stenosis, flow congestion and renal failure. Nutcracker syndrome should be suspected in older patients with left varicocele associated with hematuria. Failure to diagnose and treat these patients could have serious consequences for their health.
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