Nutcracker Syndrome
Nutcracker Syndrome
Nutcracker syndrome, also known as left renal vein entrapment, is a condition where the left renal vein (the vein that carries blood away from the left kidney) is compressed, between the superior mesenteric artery and the aorta. This compression can restrict blood flow and cause venous congestion of the left kidney with a variety of symptoms.
Why we do this scan
Ultrasound is frequently used as a first-line imaging tool for suspected Nutcracker syndrome because it's non-invasive, readily available, and can effectively visualize the left renal vein and surrounding structures. It allows for the detection of stenosis in the left renal vein, which is a key feature of the syndrome, as well as signs of kidney dysfunction
Why choose us
Compression of the left renal vein can vary with body position and breathing, so dynamic assessment is crucial. The findings in Nutcracker syndrome can be subtle, and our experienced sonographer is trained to identify these nuances, such as changes in flow velocity, the presence of collateral veins, and other indirect signs of compression.
Risk factors
Nutcracker syndrome, or left renal vein entrapment, is more common in females in their 20s and 30s, but it can affect anyone. Several factors can increase the risk of developing this condition, including rapid growth spurts during puberty, low body mass index, certain spinal conditions like lordosis, and anatomical variations in blood vessels. Tumors, aneurysms, and pregnancy can also contribute to the development of Nutcracker syndrome.
Symptoms
Left flank pain: This is a frequent symptom, often described as a dull ache or sharp pain on the left side of the abdomen.
Blood in the urine, which can be visible or microscopic.
Pelvic pain: Pain in the lower abdomen, especially during menstruation or intercourse in women.
Left-sided testicular pain: In men, the compression can lead to swelling of the scrotal veins (varicocele).
Orthostatic proteinuria: Protein in the urine that appears when standing and disappears when lying down.
Fatigue and Headaches: Some individuals may experience general fatigue and headaches.
Gastrointestinal issues: Nausea, vomiting, or bloating may occur in some cases.
Pain during sex, particularly in women.
Pain when urinating.
Complications
Complications can include kidney damage, blood clots, and pain. Untreated, it can lead to progressive renal dysfunction, blood clots in the renal vein, and potentially kidney failure.
Preparation for the ultrasound
Fasting (no eating or drinking) is required for 5 hours prior to the ultrasound. Fasting reduces the amount of gas in your abdomen, which provides clearer images of the arteries and veins. All patients should take their usual oral medications with a small amount of water. DO NOT fast if you are a Diabetic. The procedure is usually painless and involves the sonographer applying a gel to your abdomen and moving the transducer over the area. You may be asked to lie down, sit, or stand, with a number of movements such as rolling onto your side and breath holding to optimize visualization.
