Double nutcracker syndrome in a patient with circumaortic venous ring: a rare case report

• Published in: Journal of ultrasonography Vol. 23; no. 93; pp. 101 - 105
• Main Authors: Farina, Renato, Foti, Pietro Valerio, Nicolosi, Lorena, Basile, Antonio
• Format: Journal Article
• Language: English
• Published: Poland Sciendo 01-06-2023
• Subjects: cardiovascular abnormalities; Case Report; computed tomography; magnetic resonance imaging; nutcracker syndrome; ultrasound; computed tomography; nutcracker syndrome; cardiovascular abnormalities; magnetic resonance imaging; ultrasound
• ISSN: 2084-8404; 2451-070X
• DOI: 10.15557/jou.2023.0018

In this article, we describe a rare case of the nutcracker syndrome caused by combined compression of the left anteroaortic and retroaortic renal veins.
A 42-year-old woman presented with microhematuria and left flank pain. The patient underwent computed tomography and Doppler ultrasound which showed the left renal veins with anteroaortic and retroaortic courses, with signs of compression. Compression of the anteroaortic renal vein was caused by a narrowing of the aortomesenteric space, whereas compression of the retroaortic renal vein was caused by a narrowing of the aortovertebral space.
NCS is a rare disease, poorly understood and difficult to diagnose mainly due to the non-specificity of symptoms. Imaging is essential for diagnosis, and the combination of ultrasound and computed tomography allows for better classification of the disease. Increased disclosure of these cases can significantly contribute to a reduction of false negatives.