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Related Experiment Video

Updated: May 19, 2026

Diagnosis of Hirschsprung's Disease by Immunostaining Rectal Suction Biopsies for Calretinin, S100 Protein and Protein Gene Product 9.5

Diagnosis of Hirschsprung's Disease by Immunostaining Rectal Suction Biopsies for Calretinin, S100 Protein and Protein Gene Product 9.5

Published on: April 26, 2019

[Nutcracker syndrome. Hematuria without diagnosis?].

Rita Calado¹, Mónica Braz, Luísa Lobo

¹Serviço de Pediatria, Hospital Espírito Santo, Évora, Portugal.

Acta Medica Portuguesa

|August 4, 2012

Summary

Nutcracker syndrome, a condition causing left renal vein compression, often presents as hematuria in children and is frequently misdiagnosed. Early diagnosis using noninvasive tests like Doppler ultrasound is crucial for effective management.

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Area of Science:

Pediatric Nephrology
Vascular Surgery
Diagnostic Imaging

Background:

Nutcracker syndrome involves compression of the left renal vein between the aorta and superior mesenteric artery.
This compression can lead to left renal vein hypertension, causing symptoms like hematuria, abdominal pain, and pelvic congestion.

Observation:

The condition is suspected to have a significant prevalence in children with isolated hematuria.
It is often misdiagnosed, leading to delayed or incorrect treatment.
Two pediatric cases presenting with hematuria were investigated, leading to the diagnosis of Nutcracker syndrome.

Findings:

Diagnosis relies on clinical suspicion, imaging, and exclusion of other causes.
Noninvasive tests, particularly renal ultrasound with Doppler, play a vital role in diagnosis.
The study highlights the importance of considering Nutcracker syndrome in children with unexplained hematuria.

Implications:

Increased awareness of Nutcracker syndrome is needed among clinicians treating pediatric hematuria.
Timely diagnosis through noninvasive imaging can prevent complications and improve patient outcomes.
This condition underscores the importance of a comprehensive diagnostic approach for hematuria in children.