Calado Rita, Braz Mónica, Lobo Luísa, Simão Carla
Serviço de Pediatria, Hospital Espírito Santo, Évora, Portugal.
Acta Med Port. 2011 Dec;24 Suppl 3:695-8. Epub 2011 Dec 31.
The nutcracker syndrome is associated with left renal vein compression in its passage between the abdominal aorta and superior mesenteric artery. This phenomenon can cause left renal vein hypertension manifested by abdominal pain, hematuria, and pelvic congestion syndrome. The diagnosis is essentially clinical, supported by imaging and necessarily one of exclusion. The literature suggests that it occurs with a reasonable prevalence in children who present with isolated hematuria but is commonly misdiagnosed. We describe two clinical cases of children with hematuria whose investigation led to the diagnosis of Nutcracker Syndrome. In the presence of hematuria of unknown origin it's necessary to consider this entity, highlighting the essential role of a noninvasive test such as renal ultrasound with Doppler in its diagnosis.
胡桃夹综合征与左肾静脉在腹主动脉和肠系膜上动脉之间穿行时受压有关。这种现象可导致左肾静脉高压，表现为腹痛、血尿和盆腔淤血综合征。诊断主要基于临床，影像学检查可提供支持，且必须排除其他疾病。文献表明，孤立性血尿患儿中胡桃夹综合征的发生率较高，但常被误诊。我们描述了两例血尿患儿的临床病例，经检查确诊为胡桃夹综合征。在不明原因血尿的情况下，有必要考虑这一疾病，强调诸如彩色多普勒肾脏超声等无创检查在其诊断中的重要作用。
