Yawar Shujee, Shaikh Rabail Saeed, Khan M Akram
Cardiology, Cardiac Center of Texas, McKinney, USA.
Cureus. 2023 Aug 23;15(8):e43996. doi: 10.7759/cureus.43996. eCollection 2023 Aug.
Nutcracker syndrome (NCS) is an uncommon condition that predominantly affects the left renal vein (LRV) because of its entrapment between the aorta and superior mesenteric vein. It can result in pain in the left flank or back, hematuria, and proteinuria. May-Thurner syndrome (MTS) is described as a condition in which the left common iliac vein is compressed by the right common iliac artery, causing swelling, fullness, venous ulcers, or varicose veins in the leg. We present a case of a 77-year-old female who had these symptoms for over a decade, until she was diagnosed in 2017. Initially, she experienced swelling and pain in her left leg, which began in 2005; however, treatment did not begin until she had her left ovarian vein embolized in 2017. Her symptoms returned the following year, leading to the diagnosis of bilateral MTS. Owing to recurring symptoms in 2022, a repeat venogram revealed bilateral external iliac vein constriction, requiring intervention. She presented to our clinic in 2023 after being referred by her cardiologist because of persistent back pain and venous congestion. This led to the findings and diagnosis of NCS with bilateral MTS.
胡桃夹综合征（NCS）是一种罕见病症，主要影响左肾静脉（LRV），原因是其被夹在主动脉和肠系膜上静脉之间。它可导致左腰或背部疼痛、血尿和蛋白尿。May-Thurner综合征（MTS）被描述为一种左髂总静脉受右髂总动脉压迫的病症，可导致腿部肿胀、充盈、静脉溃疡或静脉曲张。我们报告一例77岁女性病例，她出现这些症状已超过十年，直至2017年才被确诊。最初，她于2005年开始出现左腿肿胀和疼痛；然而，直到2017年她接受左卵巢静脉栓塞治疗后才开始治疗。次年她的症状复发，导致双侧MTS的诊断。由于2022年症状复发，重复静脉造影显示双侧髂外静脉狭窄，需要进行干预。2023年，她因持续背痛和静脉充血被心脏病专家转诊至我们诊所。由此得出了合并双侧MTS的NCS的检查结果和诊断。
