TY - JOUR
T1 - Posterior nutcracker syndrome – A systematic review
AU - Park, Jae Hyon
AU - Lee, Gi Hoon
AU - Lee, Seul Mi
AU - Eisenhut, Michael
AU - Kronbichler, Andreas
AU - Lee, Keum Hwa
AU - Shin, Jae Il
N1 - Publisher Copyright:
© 2017 Hogrefe.
PY - 2018/1
Y1 - 2018/1
N2 - Summary: Posterior nutcracker syndrome (PNCS) is the entrapment of the left renal vein between the aorta and the vertebral column. Although uncommon, it is still an important diagnosis due to the high morbidity associated with the risk of secondary anaemia from haematuria, from long-term left renal vein hypertension, vascular thrombosis, and even blood clots in the urinary system. A literature search of PubMed and EMBASE databases was performed and 27 publications containing 27 cases were included for the final analysis. The following frequency of clinical signs and symptoms was noted: twenty-five patients had haematuria, 13 patients had flank pain, and two had hypertension. Overall, male-female distribution was balanced and there were more adult than paediatric (age < 18 years) patients. All symptoms of patients with conservative treatment were either well-controlled or under spontaneous resolution. Conservative management instead of surgical treatment should be preferred in most cases. Taken together, despite the low incidence of PNCS, its recognition and management are highly important. This systematic study explores the evidence base for conservative and medical options.
AB - Summary: Posterior nutcracker syndrome (PNCS) is the entrapment of the left renal vein between the aorta and the vertebral column. Although uncommon, it is still an important diagnosis due to the high morbidity associated with the risk of secondary anaemia from haematuria, from long-term left renal vein hypertension, vascular thrombosis, and even blood clots in the urinary system. A literature search of PubMed and EMBASE databases was performed and 27 publications containing 27 cases were included for the final analysis. The following frequency of clinical signs and symptoms was noted: twenty-five patients had haematuria, 13 patients had flank pain, and two had hypertension. Overall, male-female distribution was balanced and there were more adult than paediatric (age < 18 years) patients. All symptoms of patients with conservative treatment were either well-controlled or under spontaneous resolution. Conservative management instead of surgical treatment should be preferred in most cases. Taken together, despite the low incidence of PNCS, its recognition and management are highly important. This systematic study explores the evidence base for conservative and medical options.
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U2 - 10.1024/0301-1526/a000670
DO - 10.1024/0301-1526/a000670
M3 - Review article
C2 - 29165061
AN - SCOPUS:85039870759
VL - 47
SP - 23
EP - 29
JO - Vasa - European Journal of Vascular Medicine
JF - Vasa - European Journal of Vascular Medicine
SN - 0301-1526
IS - 1
ER -