Sawant Devendra A, Moore Thomas F
School of Anatomical Science, Alderson Broaddus University College of Medical Science, Philippi, WV 26416, USA.
School of Physician Assistant Studies, Alderson Broaddus University College of Medical Science, Philippi, WV 26416, USA.
Case Rep Med. 2015;2015:249015. doi: 10.1155/2015/249015. Epub 2015 Sep 13.
Nutcracker phenomenon or renal vein entrapment is classically seen as a compression of renal vein in between abdominal aorta and superior mesenteric artery with patients being asymptomatic or clinically manifested in the form of nutcracker syndrome as proteinuria, hematuria, flank pain, pelvic congestion in women, and varicocele in men. In this report, we are presenting a case of rare variant of nutcracker phenomenon along with brief review of anatomy, pathophysiology, public health, and clinical significance of nutcracker syndrome. On a routine dissection of an adult male cadaver, we noticed an unusual arrangement of the structures at the hilum of the left kidney showing entrapment of renal vein between left anterior inferior and posterior segmental renal arteries. The variation in the course of left anterior inferior segmental renal artery leads to compression of left renal vein at renal hilum. Therefore, we have named this rare abnormal anatomical entity as hilar nutcracker phenomenon. The structures in the right renal hilum are normal. The objective of this paper is to report an unusual but important variant of nutcracker phenomenon and also give collective knowledge of such anatomical variations in renal vasculature that will help in diagnosing and treating such rare renal disorder.
胡桃夹现象或肾静脉受压综合征通常表现为腹主动脉与肠系膜上动脉之间对肾静脉的压迫，患者可无症状，或表现为胡桃夹综合征，如蛋白尿、血尿、胁腹痛、女性盆腔淤血及男性精索静脉曲张。在本报告中，我们呈现了一例罕见的胡桃夹现象变异病例，并简要回顾了胡桃夹综合征的解剖学、病理生理学、公共卫生及临床意义。在对一具成年男性尸体进行常规解剖时，我们注意到左肾门处结构的异常排列，显示左肾静脉被左肾下前支动脉和肾后段动脉夹住。左肾下前支动脉走行的变异导致左肾静脉在肾门处受压。因此，我们将这种罕见的异常解剖实体命名为肾门胡桃夹现象。右肾门的结构正常。本文的目的是报告一种不寻常但重要的胡桃夹现象变异，并提供有关肾血管系统此类解剖变异的综合知识，这将有助于诊断和治疗这种罕见的肾脏疾病。
