Nonrotation of gut with nutcracker syndrome: a rare presentation

Authors

  • Saket Jha Department of Pediatric Surgery, Lokmanya Tilak Municipal Medical College and Hospital, Mumbai, Maharashtra, India
  • Shahaji Deshmukh Department of Pediatric Surgery, Lokmanya Tilak Municipal Medical College and Hospital, Mumbai, Maharashtra, India
  • Apoorva Kulkarni Department of Pediatric Surgery, Lokmanya Tilak Municipal Medical College and Hospital, Mumbai, Maharashtra, India
  • Abhaya Gupta Department of Pediatric Surgery, Lokmanya Tilak Municipal Medical College and Hospital, Mumbai, Maharashtra, India
  • Paras Kothari Department of Pediatric Surgery, Lokmanya Tilak Municipal Medical College and Hospital, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20213626

Keywords:

Nutcracker syndrome, Nonrotation, Malrotation

Abstract

Nutcracker syndrome is a rare diagnosis which presents with hematuria, abdominal pain and is caused by left renal vein entrapment in between abdominal aorta and superior mesenteric artery. Symptomatic presentation of rotational abnormalities of gut are rare in adults though it can present with abdominal pain. Simultaneous presence of nonrotation with nutcracker syndrome was very rarely reported in literature. The authors reported a 38 year old female who presented with chronic pain in left side of abdomen and was diagnosed as nutcracker syndrome with nonrotation of gut. Patient underwent Ladd’s procedure with left renal vein transposition. Patient was asymptomatic on follow up. Search of literature showed only two previous cases being reported making it a very rare presentation.

References

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Kurklinsky AK, Rooke TW. Nutcracker phenomenon and nutcracker syndrome. Mayo Clin Proc. 2010;85(6):552-9.

Buschi AJ, Harrison RB, Norman A, Brenbridge AG, Williamson BR, Gentry RR, et al. Distended left renal vein: CT/sonographic normal variant. AJR Am J Roentgenol. 1980;135(2):339-42.

Flüe M, Herzog U, Ackermann C, Tondelli P, Harder F. Acute and chronic presentation of intestinal nonrotation in adults. Dis Colon Rectum. 1994;37(2):192-8.

Wang CA, Welch CE. Anomalies of intestinal rotation in adolescents and adults. Surgery. 1963;54:839-55.

Spigland N, Brandt ML, Yazbeck S. Malrotation presenting beyond the neonatal period. J Pediatr Surg. 1990;25(11):1139-42.

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Published

2021-08-27

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Section

Case Reports