Department of Vascular Surgery, Beijing Chao Yang Hospital of Capital University of Medical Sciences, Beijing, China.
J Vasc Surg. 2012 Sep;56(3):816-8. doi: 10.1016/j.jvs.2012.03.021. Epub 2012 Jul 21.
Left renal vein hypertension secondary to left renal vein compression has been described as a cause of persistent hematuria in nutcracker syndrome. Malformation of the inferior vena cava (IVC), although rare and frequently asymptomatic, may also result in left renal vein hypertension, with resultant hematuria when it is severely compressed. We report a 20-year-old man with persistent hematuria due to compression of left-sided IVC. The patient was successfully treated by means of superior mesenteric artery (SMA) transposition and division of the fibrous bundle at the origin of the SMA. His postoperative course was uneventful. Compression of the left IVC is a unique form of nutcracker syndrome. SMA transposition, together with division of a fibrous bundle at the origin of the SMA if present, is a safe and effective surgical procedure for this special entity.
左肾静脉压迫引起的左肾静脉高血压已被描述为胡桃夹综合征持续性血尿的一个原因。下腔静脉（IVC）畸形虽然罕见且常无症状，但也可能导致左肾静脉高血压，当严重受压时会导致血尿。我们报告了一例因左侧 IVC 受压导致持续性血尿的 20 岁男性患者。通过肠系膜上动脉（SMA）移位和 SMA 起点处纤维束的切断，患者成功得到治疗。他的术后过程顺利。左 IVC 受压是胡桃夹综合征的一种独特形式。如果存在 SMA 起点处纤维束，SMA 移位加 SMA 起点处纤维束切断是一种安全有效的手术方法，适用于这一特殊实体。
