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[Nutcracker phenomenon treated with left renal vein transposition: a case report]
T Ohki1, M Miyahara, Y Nakajima
1Department of Urology, Ise Keio Hospital, Keio University.
Hinyokika Kiyo. Acta Urologica Japonica
|May 20, 1999
Summary
A surgical intervention successfully treated a teenage boy with severe gross hematuria caused by the nutcracker phenomenon. The left renal vein transposition resolved his painful symptoms and recurrent bleeding, offering a lasting solution.
Area of Science:
- Nephrology
- Vascular Surgery
- Pediatric Urology
Background:
- The nutcracker phenomenon (NCP) is a rare vascular condition characterized by the compression of the left renal vein.
- NCP can lead to left renal venous hypertension, causing symptoms such as flank pain and hematuria.
Observation:
- A 14-year-old male presented with severe gross hematuria, flank pain, and urinary retention due to blood clots.
- Imaging studies, including 3D CT and angiography, confirmed NCP with significant left renal venous hypertension.
Findings:
- Conservative management failed to alleviate the patient's severe symptoms.
- Surgical transposition of the left renal vein was performed, repositioning it 5.5 cm caudally.
Implications:
- Surgical correction of the nutcracker phenomenon can effectively resolve severe hematuria and associated symptoms in pediatric patients.
- Left renal vein transposition offers a viable surgical option for managing refractory NCP, improving patient outcomes and quality of life.