Nutcracker syndrome

Case contributed by Dr Mohammad Taghi Niknejad

Presentation

Workup for microscopic haematuria.

Patient Data

Age: 35 years
Gender: Female
CT

Both kidneys show normal size and position. A 75×68×59mm thin-walled cortical cyst with few thin internal septations is noted at upper pole of right kidney. No obvious calcification or enhancing soft tissue component are noted within the cyst. 
Compression of the left renal vein between the superior mesenteric artery and aorta are evident which can be causes Nutcracker syndrome. The renal pelvis and calices show a normal configuration. The urinary drainage tract is unobstructed and delayed images show symmetrical contrast excretion into the renal pelvis with no filling defect.

 

Case Discussion

In a 35 yo female with hematuria, features on CT scan are compatible with Nutcracker syndrome which is a vascular compression disorder and refers to the compression of the left renal vein between the superior mesenteric artery (SMA) and aorta. This can lead to renal venous hypertension, resulting in rupture of thin-walled veins into the collecting system with resultant hematuria.

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Case information

rID: 64593
Published: 30th Nov 2018
Last edited: 30th Nov 2018
Inclusion in quiz mode: Included
Institution: Tabesh medical imaging center

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