Ichihara Yuki, Azuma Takashi, Saito Satoshi, Niinami Hiroshi
Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan.
J Card Surg. 2021 Mar;36(3):1138-1139. doi: 10.1111/jocs.15400. Epub 2021 Feb 1.
Nutcracker syndrome (NCS) is known as a status of compression of the left renal vein (LRV) between the abdominal aorta and superior mesenteric artery (SMA). We here report a case of NCS in a Marfan syndrome patient with type B aortic dissection who was presented with sudden gross hematuria. Computed tomography revealed the compression of the LRV sandwiched between the SMA and the dilated dissecting abdominal aorta. The compression was released by surgical intervention and the hematuria was promptly resolved. This report highlights that NCS should be considered as a differential diagnosis of unexplained hematuria in patients with a chronic dissecting aorta.
胡桃夹综合征（NCS）是指左肾静脉（LRV）在腹主动脉和肠系膜上动脉（SMA）之间受压的一种状态。我们在此报告一例患有B型主动脉夹层的马凡综合征患者出现突发性肉眼血尿，诊断为胡桃夹综合征。计算机断层扫描显示LRV夹在SMA和扩张的夹层腹主动脉之间受压。通过手术干预解除了压迫，血尿迅速消失。本报告强调，对于慢性主动脉夹层患者出现无法解释的血尿时，应考虑胡桃夹综合征作为鉴别诊断。
