Dr. med. Dirk Manski

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Nutcracker Syndrome: Symptoms, Diagnosis, and Treatment


Nutcracker syndrome is the compression of the left renal vein between the superior mesenteric artery and the aorta (Kurklinsky et al., 2010).

Signs and Symptoms of Nutcracker Syndrome

The symptoms are nonspecific and variable in intensity: Left flank pain, hematuria, proteinuria, or varicocele. Typical is an aggravation when sitting and standing.


Treatment of Nutcracker Syndrome

The challenge is correlating the clinical findings and symptoms with the imaging results. A wait-and-see behavior is recommended for mild disease, collateral vessels will form and alleviate the symptoms. Percutaneous stent insertion or open surgical therapy (transposition of the renal vein) are options in patients with severe symptoms.

Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z


Kurklinsky, A. K. & Rooke, T. W. Nutcracker phenomenon and nutcracker syndrome.
2010, 85, 552-559.

  Deutsche Version: Diagnose und Therapie des Nussknacker-Syndroms