Síndrome de Cascanueces Posterior: reporte de un caso en pediatría y revisión de la literatura
DOI:
https://doi.org/10.17533/udea.iatreia.239Palabras clave:
Hematuria, Proteinuria, Pediatría, Síndrome de Cascanueces RenalResumen
El síndrome de cascanueces se produce por la compresión de la vena renal izquierda entre la aorta y la arteria mesentérica superior, este síndrome se asocia a síntomas variables e inespecíficos de congestión venosa secundarios. La forma más común del síndrome es la clásica o anterior, pero existen otras variantes atípicas, entre ellas se encuentra el síndrome de cascanueces posterior, el cual ocurre por la compresión de la vena renal izquierda entre la aorta y la columna lumbar. Se describe el caso de una paciente de 5 años con hematuria macroscópica y proteinuria leve persistentes, en la cual se descartó compromiso glomerular y, por lo atípico del cuadro clínico, se realizó angioresonancia magnética abdominal que confirmó el diagnóstico del síndrome de cascanueces posterior.
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Kurklinsky AK, Rooke TW. Nutcracker phenomenon and nutcracker syndrome. Mayo Clin Proc [Internet]. 2010;85(6):552–9. http://dx.doi.org/10.4065/mcp.2009.0586
Venkatachalam S, Bumpus K, Kapadia SR, Gray B, Lyden S, Shishehbor MH. The nutcracker syndrome. Ann Vasc Surg [Internet]. 2011;25(8):1154–64. http://dx.doi.org/10.1016/j.avsg.2011.01.002
De Schepper A. ‘Nutcracker’ phenomenon of the renal vein and venous pathology of the left kidney. J Belge Radiol. 1972;55(5):507–11.
EL-Sadr AR, Mina E. Anatomical and surgical aspects in the operative management of varicocele. Urol Cutaneous Rev [Internet]. 1950;54(5):257–62. Available from: https://pubmed.ncbi.nlm.nih.gov/15443180/
Lau JLT, Lo R, Chan FL, Wong KK. The posterior “nutcracker”: Hematuria secondary to retroaortic left renal vein. Urology [Internet]. 1986;28(5):437–9. http://dx.doi.org/10.1016/0090-4295(86)90085-3
Özkan MB, D M, Bilgici MC, D M, Hayalioglu E, D M. Anterior and posterior nutcracker syndrome accompanying left circumaortic renal vein in an adolescent. Case report. Arch Argent Pediatr [Internet]. 2016;114(2):2015–7. Available from: http://www.sap.org.ar/docs/publicaciones/archivosarg/2016/v114n2a24e.pdf
Sawant DA, Moore TF. An Unusual Course of Segmental Renal Artery Displays a Rare Case of Hilar Nutcracker Phenomenon. Case Rep Med [Internet]. 2015;2015:249015. http://dx.doi.org/10.1155/2015/249015
Polguj M, Topol M, Majos A. An unusual case of left venous renal entrapment syndrome: A new type of nutcracker phenomenon? Surg Radiol Anat [Internet]. 2013;35(3):263–7. http://dx.doi.org/10.1007/s00276-012-1027-7
Yildiz AE, Cayci FS, Genc S, Cakar N, Fitoz S. Right nutcracker syndrome associated with left-sided inferior vena cava, hemiazygos continuation and persistant left superior vena cava: A rare combination. Clin Imaging [Internet]. 2014;38(3):340–5. http://dx.doi.org/10.1016/j.clinimag.2013.12.007
Al-Zoubi NA, Al-Ghalayini IF, Al-Okour R. Nutcracker syndrome associated with celiacomesentric trunk anomaly: Case report. Int J Nephrol Renovasc Dis [Internet]. 2017;10:285–8. http://dx.doi.org/10.2147/IJNRD.S146814
Yang BZ, Li Z, Wang ZG. Nutcracker syndrome due to left-sided inferior vena cava compression and treated with superior mesenteric artery transposition. J Vasc Surg [Internet]. 2012;56(3):816–8. http://dx.doi.org/10.1016/j.jvs.2012.03.021
Basile A, Tsetis D, Calcara G, Figuera M, Coppolino F, Patti MT, et al. Nutcracker Syndrome Due to Left Renal Vein Compression by an Aberrant Right Renal Artery. Am J Kidney Dis [Internet]. 2007;50(2):326–9. https://doi.org/10.1053/j.ajkd.2007.05.016
Pulgarin-Ricardo LG, Isaza-Zapata S, Uribe-Gonzalez R. Left inferior vena cava with nutcracker syndrome: A case report. Radiol Case Reports [Internet]. 2018;13(1):32–4. https://doi.org/10.1016/j.radcr.2017.10.007
Ueda Y, Aoyagi H, Okamoto T. Left-sided inferior vena cava with nutcracker syndrome. Clin Exp Nephrol [Internet]. 2019;23(3):425–6. http://dx.doi.org/10.1007/s10157-018-1636-5
Park JH, Lee GH, Lee SM, Eisenhut M, Kronbichler A, Lee KH, et al. Posterior nutcracker syndrome - a systematic review. Vasa [Internet]. 2018;47(1):23–9. http://dx.doi.org/10.1024/0301-1526/a000670
Satyapal KS. The renal veins: A review. Eur J Anat. 2003;7(SUPPL. 1):43–52. Available from: https://www.eurjanat.com/v1/journal/paper.php?id=03S10043
Harman M, Arslan H, Temizoz O, Ceylan K, Etlik Ö, Kavan M. Incidence of retro-aortic left renal vein and its relationship with varicocele. Eur Radiol [Internet]. 2005;15(8):1717–20. http://dx.doi.org/10.1007/s00330-004-2563-2
Shah D, Qiu X, Shah A, Cao D. Posterior nutcracker syndrome with left renal vein duplication: An uncommon cause of hematuria. Int J Surg Case Rep [Internet]. 2013;4(12):1142–4. http://dx.doi.org/10.1016/j.ijscr.2013.10.012
He Y, Wu Z, Chen S, Tian L, Li D, Li M, et al. Nutcracker syndrome - How well do we know it? Urology [Internet]. 2014;83(1):12–7. http://dx.doi.org/10.1016/j.urology.2013.08.033
Breitwieser C, Asbach P, Sachs M, Rogalla P, Rodenwaldt J. Posterior “Nutcracker” phenomenon: Hemodynamic relevant aorto-retroaortal renal vein fistula leading to fatal right heart failure. Acta radiol [Internet]. 2005;46(2):193–5. http://dx.doi.org/10.1080/02841850510020923
Arteaga CM, Martín SM, González JRC, Fajardo JAG, Busto EF del. Síndrome del cascanueces posterior: Vena renal retroaórtica asociada a fístula arteriovenosa y carcinoma renal. A propósito de un caso y revisión de la literatura. Actas Urol Esp [Internet]. 2009;33(1):101–4. https://doi.org/10.1016/S0210-4806(09)74012-4
Luo XL, Qian GN, Xiao H, Zhao CL, Zhou XD. Posterior nutcracker syndrome associated with interrupted left inferior vena cava with azygos continuation and retroaortic right renal vein. Korean J Radiol [Internet]. 2012;13(3):345–9. Available from: https://pubmed.ncbi.nlm.nih.gov/22563273/
Granata A, Clementi A, Floccari F, Di Lullo L, Basile A. An unusual case of posterior nutcracker syndrome. Clin Exp Nephrol [Internet]. 2014;18(4):670–1. https://doi.org/10.1007/s10157-014-0932-y
Takebayashi S, Ueki T, Ikeda N, Fujikawa A. Diagnosis of the nutcracker syndrome with color Doppler sonography: correlation with flow patterns on retrograde left renal venography. AJR Am J Roentgenol [Internet]. 1999 Jan;172(1):39-43. https://doi.org/10.2214/ajr.172.1.9888735
Shi Y, Yang H, Feng Z, Chen F, Zhang H, Wu Z. Evaluation of posterior nutcracker phenomenon using multisection spiral CT. Clin Radiol [Internet]. 2018;73(12):1060.e9-1060.e16. https://doi.org/10.1016/j.crad.2018.07.110
Ananthan K, Onida S, Davies AH. Nutcracker Syndrome: An Update on Current Diagnostic Criteria and Management Guidelines. Eur J Vasc Endovasc Surg [Internet]. 2017;53(6):886–94. http://dx.doi.org/10.1016/j.ejvs.2017.02.015
de Macedo GL, Dos Santos MA, Sarris AB, Gomes RZ. Diagnosis and treatment of the Nutcracker syndrome: a review of the last 10 years. J Vasc Bras [Internet]. 2018 Jul-Sep;17(3):220-228. http://dx.doi.org/10.1590/1677-5449.012417
Ma Z, Liu X, Ning Y, Shao J, Liu W, He X. Nutcracker phenomenon in combination with glomerular nephritis in isolated hematuria patients. Int Urol Nephrol [Internet]. 2013;45(3):809–16. http://dx.doi.org/10.1007/s11255-012-0265-2
Alaygut D, Bayram M, Soylu A, Cakmakci H, Türkmen M, Kavukcu S. Clinical course of children with nutcracker syndrome. Urology [Internet]. 2013;82(3):686–90. http://dx.doi.org/10.1016/j.urology.2013.03.048
Montoya-Montoya C, Siegert-Ospina M, Brand-Salazar S, Flórez-Orrego J, Muñoz-Martinez L, Prada-Meza M, et al. Síndrome de cascanueces en combinación con nefropatía IgA: causa de hematuria y proteinuria persistentes. Reporte de un caso y revisión de la literatura. Iatreia [Internet]. 2018;31(4):400–6. https://doi.org/10.17533/udea.iatreia.%20v31n4a07
Miró I, Serrano A, Pérez-Ardavín J, March JA, Polo A, Conca MÁ, et al. Eighteen years of experience with pediatric nutcracker syndrome: the importance of the conservative approach. J Pediatr Urol [Internet]. 2020;16(2): 218.e1-218.e6. https://doi.org/10.1016/j.jpurol.2019.12.003
Kim MJ, Lee SM, Shin YH, Kim JH, Shin J Il, Lee JS, et al. Factors affecting spontaneous resolution of hematuria in childhood nutcracker syndrome. Pediatr Nephrol [Internet]. 2005;20(5):609–13. https://doi.org/10.1007/s00467-004-1799-z
Velasquez CA, Saeyeldin A, Zafar MA, Brownstein AJ, Erben Y. A systematic review on management of nutcracker syndrome. J Vasc Surg Venous Lymphat Disord [Internet]. 2018;6(2):271–8. https://doi.org/10.1016/j.jvsv.2017.11.005
Marone EM, Psacharopulo D, Kahlberg A, Coppi G, Chiesa R. Surgical treatment of posterior nutcracker syndrome. J Vasc Surg [Internet]. 2011;54(3):844–7. http://dx.doi.org/10.1016/j.jvs.2011.01.038
Wang X, Zhang Y, Li C, Zhang H. Results of endovascular treatment for patients with nutcracker syndrome. J Vasc Surg [Internet]. 2012;56(1):142–8. http://dx.doi.org/10.1016/j.jvs.2012.01.007
Rodríguez-Morata A, Robles-Martín ML, Reyes-Ortega JP. Endovascular treatment of posterior nutcracker syndrome with a new autoexpandable stent. J Vasc Surg Venous Lymphat Disord [Internet]. 2018;7(1):118–21. https://doi.org/10.1016/j.jvsv.2018.06.008
Allam SR, Livingston TS, Kalaria V, Diaz-Calderon W, Pumphrey JA, Patel L, et al. Posterior nutcracker syndrome: an infrequent cause of hematuria. Kidney Int [Internet]. 2014;85(4):985–6. http://linkinghub.elsevier.com/retrieve/pii/S0085253815562662
Fuentes-Perez A, Bush RL, Kalra M, Shortell C, Gloviczki P, Brigham TJ, et al. Systematic review of endovascular versus laparoscopic extravascular stenting for treatment of nutcracker syndrome. J Vasc Surg Venous Lymphat Disord [Internet]. 2023 Mar;11(2):433-441. http://dx.doi.org/ 10.1016/j.jvsv.2022.10.001
Meyer J, Rother U, Stehr M, Meyer A. Nutcracker syndrome in children: Appearance, diagnostics, and treatment - A systematic review. J Pediatr Surg [Internet]. 2022 Nov;57(11):716-722. http://dx.doi.org/ 10.1016/j.jpedsurg.2021.12.019
Ozel A, Tufaner O, Kaya E, Maldur V. US and MDCT diagnosis of a rare cause of haematuria in children: Posterior nutcracker syndrome. J Ultrasound [Internet]. 2011;14(2):89–91. http://dx.doi.org/10.1016/j.ultrasmedbio.2011.06.024
Sillo TO, Jones KE, Willetts IE. Haematuria and the retro-aortic left renal vein. BMJ Case Rep [Internet]. 2012;3–5. http://dx.doi.org/10.1136/bcr.02.2012.5836
Preza-Fernandes J, Amorim R, Gomes MJ, Oliveira V, Reis A, Ribeiro-Castro J. Posterior Nutcracker Syndrome with Left Renal Vein Duplication: A Rare Cause of Haematuria in a 12-Year-Old Boy. Case Rep Urol [Internet]. 2012;2012:1–4. https://doi.org/10.1155/2012/849681
Selami Ince, Murat Kocaoğlu, Veysel Akgün MT. Posterior nutcracker syndrome: simultaneous visualiza- tions of vessels and renal collecting system with biphasic intravenous contrast enhanced MRI. Pediatr Radiol. 2013;43(S3):459–656. https://doi.org/10.1007/s00247-013-2675-4 (abstract poster)
Chen Y, Xing J, Liu F. Left renal vein transposition is effective for posterior nutcracker syndrome. Int J Clin Exp Med [Internet]. 2014;7(12):5925–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4307582/
Guleria S, Sharma J, Chaudhary S. Retroaortic left renal vein with cascade of complications in a neonate. Indian Pediatr [Internet]. 2014;51(9):741–3. Available from: https://pubmed.ncbi.nlm.nih.gov/25228612/
Quinones-Baldrich WJ. Posterior nutcracker syndrome in a child. J Vasc Surg [Internet]. 2015;61(2):511. Available from: http://dx.doi.org/10.1016/j.jvs.2013.11.087
Abstracts for the 17th IPNA Congress, Iguaçu, Brazil, September 2016 : Poster Presentations. Pediatr Nephrol [Internet]. 2016 Oct;31(10):1765-983. https://doi.org/10.1007/s00467-016-3467-5
Abstracts for the 17th IPNA Congress, Iguaçu, Brazil, September 2016. Pediatr Nephrol [Internet]. 2016;31(10):1765–983. https://doi.org/10.1007/s00467-016-3466-6
Moriana-Domínguez CM, Borrego-Utiel FJ, Polaina-Rusillo M. Una forma rara de presentación del síndrome de cascanueces: cascanueces retroaórtico. Nefrología [Internet]. 2017;9(1):70-1. Disponible en: https://www.revistanefrologia.com/es-una-forma-rara-presentacion-del-articulo-X1888970017612416
Er A, Uzunlulu N, Guzelbey T, Yavuz S, Kiyak A, Kayhan A. The nutcracker syndrome: The usefulness of different MRI sequences for diagnosis and follow-up. Clin Imaging [Internet]. 2019;55:144–7. https://doi.org/10.1016/j.clinimag.2019.02.003
Alonso-Arroyo V, Velasco JJ, Pérez-Bertólez S, Molina ME, Marugan-de-Miguelsanz JM, Sanchez-Abuin A, et al. Pelvic Congestion Syndrome Secondary to a Circumaortic Left Renal Vein. European J Pediatr Surg Rep [Internet]. 2021;9(1):e56–e60. https://doi.org/10.1055/s-0041-1730998
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