搏动性肿块感伴剧烈腹痛；胡桃夹综合征的非典型表现。
Pulsatile Mass Sensation with Intense Abdominal Pain; Atypical Presentation of the Nutcracker Syndrome.
作者信息
Aslan Ahmet, Barutca Hakan, Kocaaslan Cemal, Orman Süleyman, Şahin Sinan
机构信息
Department of Radiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Kadiköy, Istanbul, Turkey; Department of Radiology, Ümraniye Training and Research Hospital, Ümraniye, Istanbul, Turkey (Present).
Department of Radiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Kadiköy, Istanbul, Turkey.
出版信息
Pol J Radiol. 2016 Oct 28;81:507-509. doi: 10.12659/PJR.898166. eCollection 2016.
BACKGROUND
Patients with Nutcracker syndrome generally present with nonspecific abdominal pain, with the left renal vein (LRV) lodged between the aorta and the superior mesenteric artery. In rare cases this can result in atypical gastrointestinal symptoms, making the diagnosis of Nutcracker syndrome challenging.
CASE REPORT
A 28-year-old female patient presented with complaints of severe abdominal pain and palpable pulsatile abdominal mass located in the left epigastric area. Computed tomography angiography revealed that the LRV was lodged in the aortomesenteric region with a dilated left ovarian vein and pelvic varicose veins. The upper gastrointestinal endoscopy and colonoscopy were normal. The patient was diagnosed as Nutcracker syndrome and discharged to be treated with analgesics.
CONCLUSIONS
Nutcracker syndrome can be seen with atypical gastrointestinal and vascular symptoms. Computed tomography angiography is a reliable and robust technique to prove the diagnosis of nutcracker syndrome.
背景
胡桃夹综合征患者通常表现为非特异性腹痛，左肾静脉（LRV）夹于腹主动脉和肠系膜上动脉之间。在罕见情况下，这可导致非典型胃肠道症状，使得胡桃夹综合征的诊断具有挑战性。
病例报告
一名28岁女性患者主诉严重腹痛，左中上腹可触及搏动性腹部肿块。计算机断层血管造影显示左肾静脉夹于腹主动脉肠系膜区域，伴有左侧卵巢静脉扩张和盆腔静脉曲张。上消化道内镜检查和结肠镜检查均正常。该患者被诊断为胡桃夹综合征，出院后接受镇痛药治疗。
结论
胡桃夹综合征可伴有非典型胃肠道和血管症状。计算机断层血管造影是证实胡桃夹综合征诊断的可靠且有力的技术。
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