Fortuitous Discovery of Nutcracker Syndrome During Acute Appendicitis: A Case Report.

Cureus

Radiology, Mohammed VI Center for Research & Innovation, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR.

Published: December 2022

Nutcracker syndrome (NCS) belongs to a group of rare vascular disorders. It refers to compression of the left renal vein (LRV) generally between the abdominal aorta (AA) and the superior mesenteric artery (SMA). It is one of the most unknown causes of chronic abdominal pain. Herein, we present the case of a young patient who came to the emergency department for acute abdominal pain. Patient's history revealed an uncharacterized chronic epigastric pain evolving for 13 years. The imaging showed acute appendicitis and NCS; the latter finding was the principal explanation for the patient's chronic pain. We hope that the concise and synthetized structure of this case report will help physicians acquire the necessary reflexes to notice and diagnose this already underdiagnosed syndrome.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9805363PMC
http://dx.doi.org/10.7759/cureus.32109DOI Listing

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Nutcracker syndrome (NCS) is an uncommon vascular condition caused by the compression of the left renal vein (LRN), which may result in venous hypertension and clinical symptoms, including hematuria, flank pain, and pelvic congestion. This report describes the case of a 30-year-old woman with recurrent painless macroscopic hematuria, ultimately diagnosed with NCS based on clinical and radiological findings. Computed tomography (CT) angiography revealed a reduced aortomesenteric angle and LRN compression without signs of severe venous hypertension or collateral circulation.

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