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Posterior nutcracker syndrome - a systematic review

Authors
 Jae Hyon Park  ;  Gi Hoon Lee  ;  Seul Mi Lee  ;  Michael Eisenhut  ;  Andreas Kronbichler  ;  Keum Hwa Lee  ;  Jae Il Shin 
Citation
 VASA-EUROPEAN JOURNAL OF VASCULAR MEDICINE, Vol.47(1) : 23-29, 2018 
Journal Title
VASA-EUROPEAN JOURNAL OF VASCULAR MEDICINE
ISSN
 0301-1526 
Issue Date
2018
MeSH
Pathologic/diagnosis/therapy Constriction ; Hematuria/*etiology ; Humans ; Renal Nutcracker Syndrome/complications/diagnosis/*therapy ; Renal Veins/*abnormalities
Keywords
Posterior nutcracker syndrome (PNCS) ; conservative management ; haematuria ; systematic review
Abstract
Posterior nutcracker syndrome (PNCS) is the entrapment of the left renal vein between the aorta and the vertebral column. Although uncommon, it is still an important diagnosis due to the high morbidity associated with the risk of secondary anaemia from haematuria, from long-term left renal vein hypertension, vascular thrombosis, and even blood clots in the urinary system. A literature search of PubMed and EMBASE databases was performed and 27 publications containing 27 cases were included for the final analysis. The following frequency of clinical signs and symptoms was noted: twenty-five patients had haematuria, 13 patients had flank pain, and two had hypertension. Overall, male-female distribution was balanced and there were more adult than paediatric (age < 18 years) patients. All symptoms of patients with conservative treatment were either well-controlled or under spontaneous resolution. Conservative management instead of surgical treatment should be preferred in most cases. Taken together, despite the low incidence of PNCS, its recognition and management are highly important. This systematic study explores the evidence base for conservative and medical options.
Full Text
https://econtent.hogrefe.com/doi/abs/10.1024/0301-1526/a000670
DOI
10.1024/0301-1526/a000670
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Shin, Jae Il(신재일) ORCID logo https://orcid.org/0000-0003-2326-1820
Lee, Keum Hwa(이금화) ORCID logo https://orcid.org/0000-0002-1511-9587
Lee, Seul Mi(이슬미)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161978
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