Kodama Koichi, Noda Toru, Motoi Isamu
Department of Urology, Toyama City Hospital, Toyama, Japan.
Indian J Urol. 2013 Jan;29(1):67-9. doi: 10.4103/0970-1591.109990.
We report a case of acute aortic dissection leading to compression of the left renal vein (LRV), thereby resulting in the nutcracker phenomenon. A 49-year-old previously healthy woman presented with intermittent gross hematuria and mild left flank pain of five days' duration. Laboratory examinations were within normal limits, except for the elevated C-reactive protein. Cystoscopy revealed bleeding from the left ureteral orifice. Contrast-enhanced computed tomography demonstrated acute Type B aortic dissection and compression of LRV between the enlarged aorta and superior mesenteric artery with an associated dilatation of the left gonadal vein as a collateral circulation.
我们报告一例急性主动脉夹层导致左肾静脉（LRV）受压，进而引发胡桃夹现象的病例。一名49岁既往健康的女性出现间歇性肉眼血尿及持续五天的轻度左侧腰痛。实验室检查除C反应蛋白升高外均在正常范围内。膀胱镜检查显示左侧输尿管口出血。增强计算机断层扫描显示急性B型主动脉夹层，以及在扩大的主动脉和肠系膜上动脉之间左肾静脉受压，同时伴有左侧性腺静脉扩张作为侧支循环。
