Nutcracker Phenomenon and Nutcracker Syndrome

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Presentation transcript:

Nutcracker Phenomenon and Nutcracker Syndrome Andrew K. Kurklinsky, MD, MACP, Thom W. Rooke, MD Mayo Clinic Proceedings Volume 85, Issue 6, Pages 552-559 (June 2010) DOI: 10.4065/mcp.2009.0586 Copyright © 2010 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 1 Schematic representation of nutcracker phenomenon. Hilar portion of the left renal vein and the gonadal vein are distended. Distended lumbar and azygous collaterals may be seen in some cases. Mayo Clinic Proceedings 2010 85, 552-559DOI: (10.4065/mcp.2009.0586) Copyright © 2010 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 2 Computed tomographic venogram showing nutcracker phenomenon. Left renal vein is compressed between the aorta and the superior mesenteric artery (white arrow). Left renal vein (black arrowhead) with distended hilar portion (black arrow). Mayo Clinic Proceedings 2010 85, 552-559DOI: (10.4065/mcp.2009.0586) Copyright © 2010 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 3 Computed tomographic venogram (digital reconstruction) showing grossly distended gonadal vein (white arrow) in the same patient as in Figure 2. Compression point marked by black arrow. Mayo Clinic Proceedings 2010 85, 552-559DOI: (10.4065/mcp.2009.0586) Copyright © 2010 Mayo Foundation for Medical Education and Research Terms and Conditions