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“胡桃夹现象”与下肢静脉高压的相关性：三例病例报告

Correlation between "Nutcracker phenomenon" and venous hypertension of the lower extremities: Three case reports.

作者信息

Hoshino Yuji, Yokoi Hiroyoshi

机构信息

Vascular Surgery, Fukuoka Sanno Hospital, Fukuoka, Japan.

Cardiovascular Medicine, Fukuoka Sanno Hospital, Fukuoka, Japan.

出版信息

J Vasc Surg Cases Innov Tech. 2022 Oct 30;8(4):802-806. doi: 10.1016/j.jvscit.2022.10.016. eCollection 2022 Dec.

DOI:10.1016/j.jvscit.2022.10.016
PMID:36507083
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9729917/
Abstract

We report three cases of left renal vein (LRV) compression resulting in deep venous insufficiency of the lower extremities, among which two patients showed clinical symptoms in both lower extremities. All patients were treated successfully with LRV stenting. The pathophysiology suggested that the secondary gonadal vein reflux owing to LRV compression drained into the iliac veins, resulting in a volume overload and venous hypertension in the iliocaval region. Computed tomography angiography was useful in diagnosing this condition, allowing the evaluation of LRV compression, identification of early opacification of the gonadal vein reflux, and exclusion of other pathologies resulting in deep venous insufficiency of the lower extremities.

摘要

我们报告了3例因左肾静脉（LRV）受压导致下肢深静脉功能不全的病例，其中2例患者双下肢出现临床症状。所有患者均通过LRV支架置入术成功治疗。病理生理学表明，LRV受压导致继发性性腺静脉反流，反流血液汇入髂静脉，导致髂腔静脉区域容量负荷过重和静脉高压。计算机断层血管造影有助于诊断这种情况，可评估LRV受压情况，识别性腺静脉反流的早期显影，并排除导致下肢深静脉功能不全的其他病变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2290/9729917/a5f166108b6c/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2290/9729917/5566e6e8f8f4/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2290/9729917/d924da47b743/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2290/9729917/de505daf07ad/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2290/9729917/a5f166108b6c/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2290/9729917/5566e6e8f8f4/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2290/9729917/d924da47b743/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2290/9729917/de505daf07ad/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2290/9729917/a5f166108b6c/gr4.jpg

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本文引用的文献

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Editor's Choice - European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs.编辑推荐——欧洲血管外科学会（ESVS）2022年下肢慢性静脉疾病管理临床实践指南
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Doppler US and CT Diagnosis of Nutcracker Syndrome.胡桃夹综合征的多普勒超声与 CT 诊断。
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J Vasc Surg. 2005 Aug;42(2):275-80. doi: 10.1016/j.jvs.2005.03.052.
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Diagnosis of pelvic congestion syndrome using transabdominal and transvaginal sonography.经腹和经阴道超声检查诊断盆腔淤血综合征
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Distended left renal vein: CT/sonographic normal variant.左肾静脉扩张：CT/超声检查正常变异。
AJR Am J Roentgenol. 1980 Aug;135(2):339-42. doi: 10.2214/ajr.135.2.339.