Open AccessNutcracker phenomenon: An unusual presentation of acute aortic dissection
Author(s) -
K. Kodama,
Takeshi Noda,
Isamu Motoi
Publication year - 2013
Publication title -
indian journal of urology/indian journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.333
H-Index - 30
eISSN - 1998-3824
pISSN - 0970-1591
DOI - 10.4103/0970-1591.109990
Subject(s) - medicine , superior mesenteric artery , aortic dissection , left renal vein , nutcracker syndrome , radiology , cystoscopy , aorta , flank pain , presentation (obstetrics) , collateral circulation , dissection (medical) , surgery , urinary system , inferior vena cava
We report a case of acute aortic dissection leading to compression of the left renal vein (LRV), thereby resulting in the nutcracker phenomenon. A 49-year-old previously healthy woman presented with intermittent gross hematuria and mild left flank pain of five days' duration. Laboratory examinations were within normal limits, except for the elevated C-reactive protein. Cystoscopy revealed bleeding from the left ureteral orifice. Contrast-enhanced computed tomography demonstrated acute Type B aortic dissection and compression of LRV between the enlarged aorta and superior mesenteric artery with an associated dilatation of the left gonadal vein as a collateral circulation.