Nephro urology case

Authors

  • Andreia A. Martins Department of Pediatrics, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos
  • Ivete Afonso Department of Pediatrics, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos
  • Maria Sameiro Faria Unit of Pediatric Nephrology, Department of Pediatrics, Centro Materno Infantil do Norte. Centro Hospitalar do Porto
  • Teresa Costa Unit of Pediatric Nephrology, Department of Pediatrics, Centro Materno Infantil do Norte. Centro Hospitalar do Porto
  • Armando Reis Department of Urology, Centro Hospitalar do Porto
  • Rui Machado Department of Angiology and Vascular Surgery, Centro Hospitalar do Porto
  • Conceição Mota Unit of Pediatric Nephrology, Department of Pediatrics, Centro Materno Infantil do Norte. Centro Hospitalar do Porto

DOI:

https://doi.org/10.25753/BirthGrowthMJ.v27.i2.13707

Keywords:

Hematuria, Nutcracker syndrome

Abstract

The Nutcracker Syndrome (NS) originates from the compression of the left renal vein in its trajectory, mostly between the aorta and the superior mesenteric artery, or less frequently between the aorta and the lumbar spine. Although asymptomatic in most cases, it can be a rare cause of hematuria.
We present the case of an 11-year-old male adolescent who was referred to a Pediatric Nephrology evaluation for a two-month-long gross hematuria. The patient also had anemia without hemodynamic repercussion. After the initial work-up, it was concluded to be a non-glomerular, extra-renal hematuria. Abdominal and renal ultrasound with Doppler was normal. The abdominal and pelvic computerized angiotomography revealed, after a careful examination, the presence of NS. Due to persistent gross hematuria with the need for transfusional support, at the age 13, the patient underwent a renal autotransplantation.
The diagnosis of NS is essentially clinical, imagiological and necessarily a diagnosis of exclusion. The treatment must be individualized and requires a multifactorial approach.

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References

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Barka M, Mallat F, Hmida W, Chavey SO, Ahmed KB, Abdallah AB, et al. Posterior nutcracker syndrome with left renal vein duplication as a cause of gross hematuria and recurrent left varicocelo in an eight-year-old boy. Int J Case Rep Images 2014 ;5:572-5.

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Machado M, Machado R, Mendes D, Almeida R. May-Thurner syndrome associated with a nutcracker syndrome, clinical case and literature review. Angiologia e Cirurgia Vascular. 2017; 2: 52-6.

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Published

2018-07-13

How to Cite

1.
Martins AA, Afonso I, Faria MS, Costa T, Reis A, Machado R, et al. Nephro urology case. BGMJ [Internet]. 2018 Jul. 13 [cited 2025 Dec. 10];27(2):133-6. Available from: https://revistas.rcaap.pt/bgmj/article/view/13707

Issue

Vol. 27 No. 2 (2018)

Section

Image Cases

License

Copyright (c) 2018 NASCER E CRESCER - BIRTH AND GROWTH MEDICAL JOURNAL

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