Aparato Digestivo, Hospital Universitario Clínico San Cecilio, España.
Radiodiagnóstico, Hospital Universitario Clínico San Cecilio, España.
Rev Esp Enferm Dig. 2021 May;113(5):372-374. doi: 10.17235/reed.2021.7580/2020.
A 67-year-old female was referred due to epigastric pain, vomiting and weight loss of 6 kg in the past months. Blood tests were performed showing hematuria. An abdominal Doppler ultrasound did not show anything abnormal. Thus, an abdominal computed tomography (CT) angiography and a magnetic resonance imaging (MRI) enterography were performed, objectifying an aortomesenteric angle of 10.8° (reference range 38-56°), which caused a complete collapse of the left renal vein ("nutcracker phenomenon") and duodenal compression with retrograde dilatation ("Wilkie syndrome"). Conservative measures and nutritional support were adopted during hospitalization. She was discharged due to a good tolerance to an oral diet, the absence of symptoms and a good contrast pass in the esophagogastroduodenal transit.
一位 67 岁女性因上腹痛、呕吐和过去几个月体重减轻 6 公斤而被转介。血液检查显示血尿。腹部多普勒超声未显示异常。因此，进行了腹部 CT 血管造影和 MRI 肠造影，客观显示主动脉肠系膜夹角为 10.8°（参考范围 38-56°），导致左肾静脉完全塌陷（“胡桃夹现象”）和十二指肠受压伴逆行扩张（“威尔基综合征”）。住院期间采用保守治疗和营养支持。由于她对口服饮食有良好的耐受性，症状消失，并且上消化道通过对比剂良好，因此她出院了。
