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육안적 혈뇨를 동반한 Nutcracker Syndrome 환자 1예

Other Titles
 A Case of Nutcracker Syndrome in a Patient with Gross Hermaturia 
Authors
 안철우  ;  서정건  ;  권건호  ;  노현진  ;  박형천  ;  강신욱  ;  최규헌  ;  윤정이  ;  전노원  ;  노정우  ;  양승철  ;  한대석  ;  이호영 
Citation
 Korean Journal of Nephrology (대한신장학회지), Vol.17(1) : 145-150, 1998 
Journal Title
 Korean Journal of Nephrology (대한신장학회지) 
ISSN
 1225-0015 
Issue Date
1998
Abstract
Nutcracker syndrome(renal vein entrapment syndrome) is probably more common than previously suspected. The nutcracker phenomenon refers to compression of left renal vein between aorta and superior mesenteric artery that results in elevation of pressure in left renal vein and development of collateral veins. This syndrome occurs in relatively young and preciously healthy patients and is characterized by intermittent gross hematuria due to left renal vein hypertension, at times associated with flank pain, abdominal pain of varicocele. We report a 17 years-old male patient with this syndrome presented with flank pain, abdominal pain, and intermittent gross hematuria for 3 months. Urinalysis revealed protein(-), blood(+++), many RBC with only 1% of dysmorphic RBC. IVP and cystoscopy showed no remarkable finding but doppler ultrasonography and abdominal spiral CT revealed compression of left renal vein between aorta and superior mesenteric artery. Renal venography showed compression of left renal vein and collateral circulation to left gonadal vein and the pressure gradient between left renal vein and inferior versa cave was 11mmHg. The nutcracker syndrome should be considered as one of the causes of nonglomerular hematuria. All patients with unexplained severe left flank or abdominal pain, or unilateral hematuria from the left on cystoscopy, should be studied by selective renal venography and pressure measurement in inferior vena cava and renal veins. The patient with this typical syndrome could be treated surgically, by transposition of left renal vein and resection of collateral veins as the procedure of choice to correct the underlying pathologic process and eliminate these troublesome symptoms.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Park, Hyeong Cheon(박형천) ORCID logo https://orcid.org/0000-0002-1550-0812
Ahn, Chul Woo(안철우) ORCID logo https://orcid.org/0000-0003-3733-7486
Choi, Kyu Hun(최규헌) ORCID logo https://orcid.org/0000-0003-0095-9011
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/176537
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