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Nutcracker Syndrome

Sometimes a patient’s inherent anatomy can affect their physical state. This is the case with nutcracker syndrome.

Definition of Nutcracker Syndrome

In Nutcracker Syndrome, the left renal vein is compressed between the abdominal aorta and superior mesenteric artery, acting like a nutcracker.

Anatomy of Nutcracker Syndrome

The left renal vein stretches over the aorta to join the inferior vena cava. The superior mesenteric artery arises above this level and drapes over the left renal vein. If the angle between the superior mesenteric artery is very small this can cause compression of the left renal vein and block blood flow back to the heart. This can then cause hematuria (blood in the urine), left sided flank pain, and pelvic varicosities.

Cause of Nutcracker Syndrome

The cause of nutcracker syndromeis anatomic. However, some people may have anatomy that should cause left renal vein compression, but have no signs or symptoms. The exact reason behind this phenomenon is still under investigation.

Symptoms of Nutcracker Syndrome

Because the left renal vein is compressed between the abdominal aorta and the superior mesenteric artery, all of the symptoms of nutcracker syndrome develop as a result of this compression. Symptoms include:

  • Hematuria, or the presence of blood in the urine
  • Abdominal pain, specifically in the left flank region or pelvic region
  • Left testicular pain due to blood backing up into the left gonadal vein
  • Varicocele formation

Diagnosis of Nutcracker Syndrome

Nutcracker syndrome is typically diagnosed on a variety of imaging modalities including left renal venography, CT scanning, and an abdominal ultrasound. These are combined with the clinical signs and symptoms to make the diagnosis.

Prevention of Nutcracker Syndrome

This is an anatomical syndrome. There is no way to prevent this.

Am I At Risk?

There are no known risk factors for Nutcracker Syndrome. However, people who have this syndrome present in their family history may be at an increased risk.

Treatment of Nutcracker Syndrome

Endovascular as well as open therapies are available for the treatment of nutcracker syndrome. Endovascular therapy involves stent placement in the left renal vein. This is a minimally invasive method with encouraging results. However, open therapy with a bypass or re-implantation remains the gold standard.

To learn more about treatment procedures for this condition please visit the following: Procedures We Do

Nutcracker syndrome can have serious consequences and deserves the attention of a profound vascular surgeon. Insightful surgeons like Dr. Jenna Kazil spend years training and treating Nutcracker syndrome. Patients in need of Nutcracker syndrome treatment on Florida’s West Coast should locate an omniscient vascular surgeon who has the surgical skills necessary to perform these serious surgical operations for the benefit of their patients. Dr. J. Kazil is a sophisticated vascular surgeon who has developed an impressive track record of successful cases in treating Nutcracker syndrome. Dr. Kazil understands the important circumstances that drive the treatment with the accuracy and compassion that everyone expects from a high-caliber vascular surgeon.Jenna Kazil, MD, FACS, RPVI is a well-rounded surgical specialist working as a vascular and general surgeon seeing patients from South Sarasota to East Desoto and Hardee to North Hillsborough to West Manatee and Pinellas counties. Patients requiring Nutcracker syndrome treatment should contact Dr. Kazil at the Florida Surgical Clinic located in Bradenton, FL today to schedule an appointment with a unique experienced surgeon that possesses a unique blend of expert skills and compassionate care.

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