Surgical management of Nutcracker syndrome caused by a middle mesenteric artery in an adolescent.

Abdel Kémal Bori Bata, Serge Metchihoungbe, Ahmad Ibrahim, Koto Toualouth Lafia, Patrick Stéphane Mfin Kouomboua, Ernest Ahounou

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Article in Journal of vascular surgery cases and innovative techniques, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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6 authors.

Abdel Kémal Bori BataUniversity Visceral Surgery Clinic (CNHU-HKM), Faculty of Health Sciences, University of Abomey-Calavi, Abomey-Calavi, Benin.

Serge MetchihoungbeUniversity Pediatric Surgery Clinic (CNHU-HKM), Faculty of Health Sciences, University of Abomey-Calavi, Abomey-Calavi, Benin.

Ahmad IbrahimUniversity Cardiology Clinic (CNHU-HKM), Faculty of Health Sciences, University of Abomey-Calavi, Abomey-Calavi, Benin.

Koto Toualouth LafiaUniversity Pediatric Surgery Clinic (CNHU-HKM), Faculty of Health Sciences, University of Abomey-Calavi, Abomey-Calavi, Benin.

Patrick Stéphane Mfin KouombouaMultipurpose University Clinic of Anesthesia and Resuscitation (CNHU-HKM), Faculty of Health Sciences, University of Abomey-Calavi, Abomey-Calavi, Benin.

Ernest AhounouMultipurpose University Clinic of Anesthesia and Resuscitation (CNHU-HKM), Faculty of Health Sciences, University of Abomey-Calavi, Abomey-Calavi, Benin.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Nutcracker syndrome is a rare condition usually caused by compression of the left renal vein between the aorta and superior mesenteric artery. The middle mesenteric artery (MMA) is an exceptional anatomical variant, reported in only 27 cases, most often incidentally. We describe an 18-year-old patient with chronic left flank pain and left varicocele. Computed tomography angiography confirmed compression of the left renal vein by the MMA (compression ratio, 3.0; angle. 14°). Surgical division, transposition, and orthotopic reimplantation were performed successfully. Recognition of rare vascular variants such as the MMA is crucial for accurate diagnosis and appropriate surgical management.

Indexed as

Middle mesenteric arteryNutcracker syndromeVascular surgical procedures

Identifiers

PMID41532022

DOI10.1016/j.jvscit.2025.102074

PMCPMC12794411

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LicenceCC BY-NC-ND

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