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Nutcracker phenomenon: An unusual presentation of acute aortic dissection
Koichi Kodama1, Toru Noda, Isamu Motoi
1Department of Urology, Toyama City Hospital, Toyama, Japan.
Summary
Acute aortic dissection can compress the left renal vein (LRV), causing the nutcracker phenomenon. This rare case highlights a unique presentation of hematuria due to LRV compression by aortic dissection.
Area of Science:
- Vascular Surgery
- Nephrology
- Radiology
Background:
- Acute aortic dissection is a life-threatening condition.
- Nutcracker phenomenon involves the compression of the left renal vein.
Observation:
- A 49-year-old woman presented with hematuria and left flank pain.
- She was diagnosed with acute Type B aortic dissection.
Findings:
- The aortic dissection compressed the left renal vein (LRV).
- This resulted in the nutcracker phenomenon, evidenced by left ureteral bleeding.
- Dilated left gonadal vein served as collateral circulation.
Implications:
- This case expands the known complications of aortic dissection.
- It underscores the importance of considering vascular compression in unexplained hematuria.
- Radiological imaging is crucial for diagnosing such complex vascular interactions.
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