Concomitant Nutcracker syndrome with superior mesenteric artery syndrome
Long-standing vague abdominal symptoms, recurrent gastro-esophageal reflux and vomiting. No hematuria or left renal colic.
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There is a reduced aortomesenteric angle having the following criteria:
Reduced aortomesenteric distance and aortomesenteric angle, measuring 4 mm and 23 degrees, respectively.
Fluid-filled stomach and 1st part of the duodenum with tapering of the retromesenteric 3rd duodenal part suggestive of its compression. Entrapment of the left renal vein and mild stenosis of its lumen.
Normally, the aortomesenteric angle and aortomesenteric distance are 25-60° and 10-28 mm, respectively.