Syed Fahd, Lam Quynh, Maharjan Najindra, Portilla Didier, Smeds Matthew R, Borja-Cacho Daniel
J Ark Med Soc. 2015 May;111(12):254-6.
The syndrome of loin pain hematuria in the absence of stones is poorly understood but must be considered in the differential diagnosis for patients with clinical manifestations resembling nephrolithiasis. A 22-year-old white female with a 4-year history of left flank pain and hematuria underwent an extensive workup with normal renal ultrasound and cystourethroscopies. CT scan and MRI revealed a retro-aortic left renal vein. Posterior nutcracker syndrome was considered the most likely diagnosis. The patient underwent a left laparoscopic nephrectomy with auto-transplantation in the right iliac fossa. She developed azotemia shortly after, which resolved and since then has become asymptomatic.
无结石情况下的腰腹痛血尿综合征目前了解甚少，但对于临床表现类似肾结石的患者进行鉴别诊断时必须考虑到该综合征。一名有4年左侧胁腹疼痛和血尿病史的22岁白人女性接受了全面检查，肾脏超声及膀胱尿道镜检查均正常。CT扫描和MRI显示左肾静脉位于主动脉后方。胡桃夹综合征被认为是最可能的诊断。该患者接受了左侧腹腔镜肾切除术并将肾脏自体移植至右髂窝。术后不久她出现了氮质血症，但随后病情缓解，自此一直无症状。
