症例(증례) : 간헐적으로 육안적 혈뇨를 동반한 Nutcracker Syndrome 1예 = Case Reports : A Case of Nutcracker Syndrome with Internittent Gross Hematuria

다국어 초록 (Multilingual Abstract)

Nutcracker syndrome (renal vein entrapment syndrome) refers to compression of left renal vein between aorta and superior mesenteric artery that results in elevation of pressure in left renal vein and development of collateral veins. This syndrome occurs in relatively young and previously healthy patients and is characterized by intermittent gross hematuria due to left renal vein hypertension, at times associated with flank pain, abdominal pain or varicocele. We report a 22 year ole male patient with this syndrome presented with intermittent gross hematuria, proteinuria for 2 months. Urinalysis revealed protein (3+), blood (++), and RBC (many/HPF). Excretory urography in resting state and cystoscopy showed no remarkable finding. Renal venography showed the pressure gradient between left renal vein and inferior vena cava was 6 mmHg. The nutcracker syndrome should be considered as one of the causes of nonglomerular hematuria. All patients with unexplained severe left flank or abdominal pain, or unilateral hematuria from the left on cytoscopy, should be studied by selective renal venography and pressure measurement in inferior vena cava and renal veins. The paitent with this nutcracker syndrome could be treated with conservative treatment.