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- Researchers from the Mayo Clinic confirm my concept of the Midline Congestion Syndrome
- Musculoskeletal pecularities of female puberty
- Lordosis /Swayback- Origin of many abdominal compression syndromes
- Nutcracker-Syndrome is a misnomer! Lordogenetic left renal vein compression is a more appropriate name!
- May-Thurner-constellation (May-Thurner-syndrome, Cockett’s syndrome)
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- Evlauation of vascular compressions with the PixelFlux-method
- Connective tissue disorders predispose to multiple compressions
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- Gradually increasing, unbearable pain in the left flank only when standing or sitting – first description of a new compression syndrome
- Abdominal pain due to liver compression in slipping rib syndrome in an EDS patient
- Genital and sexual symptoms of vascular compression syndromes – patient with ulcer of labia minora
- Posture dependent left flank / thoracic / lumbar pain – a new compression syndrome I recently detected
- Posture dependent unbearable breathlessness and fullness in the right upper abdomen due to a variable diaphragmatic compression of the hepatic veins and the vena cava inferior
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Under false flag-the so-called nutcracker syndrome (original paper)
Thomas Scholbach
Praxis für spezielle Ultraschalldiagnostik, Rödelstraße 24, 04229 Leipzig, Telefon: 0341/6880219; E-Mail: praxis.scholbach@posteo.de
Wilhelm Sandmann
Sektion Gefäßchirurgie, Clinic Bel Etage, Prof. em. für Chirurgie und Gefäßchirurgie, ehem. Direktor der Klinik für Gefäßchirurgie und Nierentransplantation, Heinrich – Heine Univ. Düsseldorf w.sandmann@gmx.de
Abstract
The compression of the left renal vein at the crossing with the midline by the aorta or the right renal artery is an underdiagnosed condition usually described as nutcracker syndrome. The underlying cause in the mainly female patients is an increased lumbar lordosis shifting the aorta ventrally thus stretching and compressing the left renal vein. The contribution of the superior mesenteric artery is rarely significant. To enhance its comprehension, we thus coined the term lordogenetic left renal vein compression.
The clinical symptoms consist of left-sided pain in the flank, hypochondrium, back and head as well as post-prandial pain in the left upper abdomen. A thorough and detailed colour Doppler sonographic examination is our diagnostic method of choice. We quantify collateral pathways with the PixelFlux-technique and operate by prolongation of the left renal vein or external PTFE shielding of the left renal vein.
Keywords: nutcracker syndrome; lordogenetic renal vein compression; color duplex sonography; perfusion quantification; functional diagnosis. EHLERS-DANLOS Syndrome
