Nutcracker Syndrome
| Classification according to ICD-10 | |
|---|---|
| I87.1 | Vein compression |
| ICD-10 online (WHO version 2019) | |
The nutcracker syndrome is a clinically manifest variant of a nutcracker phenomenon caused by impingement of the left renal vein between the superior mesenteric artery and the abdominal aorta .
Symptoms
Often there are no complaints. However, there is rarely a venous outflow disorder of the ovarian vein (vena ovarica), testicular vein ( varicocele ) and the formation of varicose veins in the veins of the small pelvis. Blood ( hematuria ) and protein ( proteinuria ) can be detected in the urine , especially when the body is upright ( orthostatic proteinuria ). Occasionally there is pain in the abdomen or left flank.
In men, pain in the testicles and disorders of sperm formation (spermatogenesis) can occur as a result of the varicocele . In women, the formation of varicose veins in the pelvis can lead to tenderness in the ovaries and pain during sexual intercourse ( dyspareunia ).
Diagnosis
Search methods are Doppler sonography , computed tomography , magnetic resonance tomography . The diagnosis is confirmed by visualizing the renal vein with contrast agent (phlebography) and measuring the pressure in the renal vein and inferior vena cava .
therapy
Surgical treatment methods include removal of the left kidney (nephrectomy) , surgical fixation of the kidney (nephropexy) , surgical diversion of the renal vein or transplantation of the left kidney into the pelvis ( autotransplantation ). Alternatively, a stent can be inserted into the left renal vein using a catheter to keep it open.
swell
- Antonio Granata et al .: Quiz Page August 2007 . In: American Journal of Kidney Diseases . No. 50 , 2007, p. A43-A44 ( article ).
