J Behcet Uz Child Hosp. 2021; 11(1): 9-14 | DOI: 10.5222/buchd.2021.54366
Our Clinical Experiences in Patients with Nutcracker Syndrome Hatice Sonay Yalcin Comert1, Elif Bahat Özdoğan2, Sema Tural Bozoğlu1, Gül Şalcı1, Haluk Sarıhan1, Mustafa Imamoğlu1 1Karadeniz Technical University, Faculty Of Medicine, Department Of Pediatric Surgery, Trabzon, Turkey 2Karadeniz Technical University, Faculty Of Medicine, Department Of Pediatric Nephrology, Trabzon, Turkey INTRODUCTION: Nutcracker syndrome (NCS) is a rare condition caused by the compression of the left renal vein between the abdominal aorta and superior mesenteric artery. The purpose of the study was to evaluate our management of NCS. METHODS: Patients were retrospectively reviewed and sex, age, main symptoms at application, physical examination, radiological findings, laboratory examinations, and treatment were recorded. RESULTS: 23 patients (16 girls, 7 boys; age range, 5 to 16) diagnosed with NCS. Microhematuria was detected with 14 (60.8%) patients before diagnosis. And four of 9 (39.1%) were determined after diagnosis. Microhematuria was not detected in 5 (21.7%) of the patients. All patients (100%) had orthostatic proteinuria. 17 (73.9%) patients had mild, 3 (13.0%) patients had moderate and 3 (13.0%) had severe proteinuria. The mean diameter of the left renal vein (LRV) at the aortomesenteric (AM) portions and the hilar were 1.69mm±0.70 and 8.01mm±2.27. The mean angle between the superior mesenteric artery and LRV was 25.26º±7.98. DISCUSSION AND CONCLUSION: In the case of especially colic flank pain, hematuria, and proteinuria NCS should keep in mind in the differential diagnosis. Surgical management may supply more enough clinic improvement when the patient has a response to medical therapy. Keywords: Nutcracker syndrome, renal colic, hematuria, proteinuria Nutcracker Sendromlu Hastalarda Klinik Deneyimlerimiz Hatice Sonay Yalcin Comert1, Elif Bahat Özdoğan2, Sema Tural Bozoğlu1, Gül Şalcı1, Haluk Sarıhan1, Mustafa Imamoğlu1 1Karadeniz Teknik Üniversitesi Tıp Fakültesi, Çocuk Cerrahisi Anabilim Dalı, Trabzon 2Karadeniz Teknik Üniversitesi Tıp Fakültesi, Çocuk Nefrolojisi Anabilim Dalı, Trabzon GİRİŞ ve AMAÇ: Nutcracker sendromu (NCS), abdominal aorto ve superiar mezenterik arter arasındaki sol renal venin sıkışmasından kaynaklanan nadir bir durumdur. Çalışmanın amacı, NCS tanısı konulan hastalara genel yaklaşımımızı değerlendirmektir. YÖNTEM ve GEREÇLER: Hastalar retrospektif olarak incelendi ve cinsiyet, yaş, uygulamadaki ana semptomlar, fizik muayene, radyolojik bulgular, laboratuvar muayeneleri ve tedavi kaydedildi. BULGULAR: 23 hasta (16 kız, 7 erkek; yaş aralığı, 5-16) NKS tanısı aldı. Tanıdan önce 14 hastada (% 60,8) mikrohematüri saptandı. Teşhisten 9 taneden dördünde (% 39.1) tanı aldıktan sonra belirlendi. Hastaların 5'inde (% 21.7) mikrohematüri saptanmadı. Tüm hastalarda (% 100) ortostatik proteinüri vardı. 17 (% 73.9) hastada hafif, 3 (% 13.0) hastada orta, 3 (% 13.0) hastada ciddi proteinüri vardı. Aortmezenterik (AM) ve hilerde sol renal venin (LRV) ortalama çapı 1.69mm ± 0.70 ve 8.01mm ± 2.27 idi. Üst mezenterik arter ve LRV arasındaki ortalama açı 25.26 ± 7.98 idi. TARTIŞMA ve SONUÇ: Özellikle kolik yan ağrısı, hematüri ve proteinüri olması durumunda NCS ayırıcı tanıda akılda tutulmalıdır. Cerrahi tedavi, hasta tıbbi tedaviye yanıt verdiğinde daha fazla klinik iyileşme sağlayabilir. Anahtar Kelimeler: Nutcracker sendromu, renal kolik, hematüri, proteinüri Hatice Sonay Yalcin Comert, Elif Bahat Özdoğan, Sema Tural Bozoğlu, Gül Şalcı, Haluk Sarıhan, Mustafa Imamoğlu. Our Clinical Experiences in Patients with Nutcracker Syndrome. J Behcet Uz Child Hosp. 2021; 11(1): 9-14 Corresponding Author: Hatice Sonay Yalcin Comert, Türkiye	TOOLS Full Text PDF Print Download citation RIS EndNote BibTex Medlars Procite Reference Manager Share with email Share Send email to author Similar articles PubMed Google Scholar  (32 accesses)  (454 downloaded)

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