User:Mr. Ibrahem/Nutcracker syndrome

Nutcracker syndrome (NCS) is a condition that occurs when the left vein from the kidney becomes compressed. Some may have no symptoms, while other develop blood in the urine, flank pain, pelvic pain, or lightheadedness with standing. Males may develop a varicocele on the left side. Other complications may include clotting of the vein, and kidney problems.

Compression most commonly occurs between the abdominal aorta (AA) and superior mesenteric artery (SMA), though compression may also occur between the aorta and spine. Risk factors include retroperitoneal cancers, abdominal aortic aneurysm, low body mass index, lordosis, and enlarged lymph nodes around the aorta. Diagnostic may be suspected based on symptoms and confirmed by medical imaging after ruling out other possible causes. Superior mesenteric artery syndrome is a different condition in which the duodenum is compressed between the the SMA and AA.

How best to treat the condition is often not clear. If symptoms are mild conservative management and weight gain in those who are slender may be recommended. Surgery may be recommended if the urine is visibly bloody, significant dysfunction occurs, or the condition does not improve after 6 to 24 months of observation. Surgery may involve the placement of an endovascular stent, be done laparoscopically, or with an open technique. In children the condition may resolve with time.

While it has been described as rare, how commonly it occurs is not clear. Onset is most often in peoples 20s to 30s. The condition was first described in 1937 by Grant. The term itself; however, did not come into use until 1971 by Chait. The name derives from the compression of the vein appearing to be a nutcracker crushing a nut.