logo
Cardiovascular Surgery News
Scientific and Information Journal




a:2:{s:4:"TEXT";s:101:"Surgical treatment of the aortomesenteric left renal vein compression syndrome in an 8-year-old child";s:4:"TYPE";s:4:"HTML";}


Authors: Arakelyan V.S., Demidova O.A., Bortnikova N.V.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

Heading: Case reports

UDC: 616.146.2-007.271-053.5-089

Link: Clinical Physiology of Blood Circulaiton. 2018; 2 (2): 98-101

Quote as: Arakelyan V.S., Demidova O.A., Bortnikova N.V. Surgical treatment of the aortomesenteric left renal vein compression syndrome in an 8-year-old child. Cardiovascular Surgery News. 2018; 2 (2): 98–101 (in Russ.). DOI: 10.24183/2588-0284-2018- 2-2-98-101

Received / Accepted:  April 16, 2018 / April 27, 2018

Full text:  


Abstract

The successful case of the surgical treatment of an 8-year-old patient with the aortomesenteric left renal vein compression syndrome is presented. The clinical manifestations of the syndrome were feeling of heaviness in the left lumbar area at long-lasting vertical position, hematuria and arterial hypertension. In the examination complex, high-informative methods for visualization of this defect were used: ultrasonic duplex scanning and computed tomography angiography. From different types of sugery used at this pathology, the most perspective, according to the literature, method of left renal vein transposition in the distal direction was chosen. As the result of the operation, the left renal vein compression was completely eliminated, the venous outflow from the left kidney restored, the kidney size normalized, hematuria disappeared. Due to elimination of the left kidney discomfort the arterial blood pressure normalized. The retroperitoneal approach we used provided not only the sufficient review of all elements participating in the reconstruction, but also the improvement of the left kidney mobility (bandaging of the veins draining it wasn't required).

Conflict of interest. The authors declare no conflict of interest.

References

  1. Grant J.C.B. Method of anatomy. 1st ed. Baltimore: William Wood & Co.; 1937: 158–9.

  2. Гаврилов С.Г., Чепуров А.К., Янина А.М. Аортомезентериальная компрессия левой почечной вены как фактор развития варикозной болезни вен таза. Анналы хирургии. 2011; 5: 18–23. [Gavrilov S.G., Chepurov A.K., Yanina A.M. Aortomesenteric compression of left renal vein as a development factor of varicose disease of pelvic veins. Russian Journal of Surgery. 2011; 5: 18–23 (in Russ.).]

  3. El Sadr A.R., Mina E. Anatomical and surgical aspects in the operative management of varicocele. Urol. Cutaneous Rev. 1950; 54 (5): 257–62.

  4. De Schepper A. “Nutcracker” phenomenon of the renal vein and venous pathology of the left kidney. J. Belge Radiol. 1972; 55 (5): 507–11.

  5. Satyapal K.S. The renal veins: a review. Eur. J. Anat. 2003; 7 (Suppl. 1): 43–52.

  6. Fitoz S., Ekim M., Ozcakar Z.B., Elhan A.H., Yalcinkaya F. Nutcracker syndrome in children: the role of upright position examination and superior mesenteric artery angle measure- ment in the diagnosis. J. Ultrasound Med. 2007; 26 (5): 573–80. DOI: 10.7863/jum.2007.26.5.573

  7. Takahashi Y., Ohta S., Sano A., Kuroda Y., Kaji Y., Matsuki M., Matsuo M. Does severe nutcracker phenomenon cause pedi- atric fatigue? Clin. Nephrol. 2000; 53 (3): 174–81.

  8. Hilgard P., Oberholzer K., Meyer zum Buschenfelde K.H., Hohenfellner R., Gerken G. The "nutcracker syndrome" of the renal vein (superior mesenteric artery syndrome) as the cause of gastrointestinal complaints. Dtsch. Med. Wohenschr. 1998; 123 (31–32): 936–40 (in German). DOI: 10.1055/s-2007-1024101

  9. Kim S.H., Cho S.W., Kim H.D., Chung J.W., Park J.H., Han M.C. Nutcracker syndrome: diagnosis with Doppler US. Radiology. 1996; 198 (1): 93–7. DOI: 10.1148/radiology.198.1.8539413

  10. Hartung O., Grisoli D., Boufi M., Marani I., Hakam Z., Barthelemy P., Alimi Y.S. Endovascular stenting in the treatment of pelvic vein congestion caused by nutcracker syndrome: lessons learned from the first five cases. J. Vasc. Surg. 2005; 42 (2): 275–80. DOI: 10.1016/j.jvs.2005.03.052

  11. Хартинг О. Синдром сдавления левой почечной вены в аорто-мезентериальном пинцете (nutcracker syndrome). Флеболимфология. 2010; 36: 10–5. [Kharting О. Aortomesenteric left renal vein compression syndrome (nutcracker syndrome). Flebolimfologiya (Phlebolymphology). 2010; 36: 10–5 (in Russ.).]

  12. Gloviczki P., Kalra M., Duncan A.A. et al. Nutcracker syndrome: left renal vein transposition. The first line treatment. In: Becquemin J.B., Alimi Y.S., Gerard J.L. (Eds.) Controversies and updates in vascular surgery. Torino, Italy: Edizioni Minerva Medica; 2008: 360–6.

  13. Reed N.R., Kalra M., Bower T.C., Vrtiska T.J., Ricotta J.J. 2nd, Gloviczki P. Left renal vein transposition for nutcracker syndrome. J. Vasc. Surg. 2009; 49 (2): 386–93. DOI: 10.1016/j.jvs.2008.09.051

About Authors


© Bakoulev National Medical Research Center for Cardiovascular Surgery,
Ministry of Health of the Russian Federation

Privacy Policy (in Russian)

Produced by
Bakoulev CCVS IT Departament