Rogers Alistair, Beech Andrew, Braithwaite Bruce
Department of Vascular Surgery, Nottingham University Hospitals Trust, Queens Medical Centre, Nottingham, UK.
Vascular. 2007 Jul-Aug;15(4):238-40. doi: 10.2310/6670.2007.00034.
The nutcracker phenomenon refers to compression of the left renal vein at the origin of the superior mesenteric artery and is often underdiagnosed. This can cause symptoms of pelvic venous congestion with retrograde venous flow and a dilated gonadal vein. Here we describe a case in a 39-year-old female, who following imaging investigations to confirm the diagnosis, underwent transperitoneal laparoscopic ligation of the left gonadal vein. Laparoscopic sterilization was also performed with the aid of the gynecologists. Multiparous women, who are more likely to develop pelvic congestion symptoms, more commonly request sterilization and thus we propose that a dual laparoscopic procedure in these cases could be the treatment of choice.
胡桃夹现象是指肠系膜上动脉起始处对左肾静脉的压迫，且常常诊断不足。这可导致盆腔静脉淤血症状，伴有静脉逆流和性腺静脉扩张。在此，我们描述一例39岁女性病例，在经过影像学检查确诊后，接受了经腹腹腔镜下左性腺静脉结扎术。同时在妇科医生协助下进行了腹腔镜绝育术。经产妇更易出现盆腔淤血症状，也更常要求绝育，因此我们建议在这些病例中采用双腹腔镜手术可能是首选治疗方法。
