Key result
Conservative weight gain management relieves gastrointestinal symptoms in a patient with Nutcracker and Wilkie's syndromes.
Why the study?
The coexistence of nutcracker syndrome and Wilkie's syndrome is extremely rare and requires clinical awareness for diagnosis and management.
Case Report (n=1)
The coexistence of Nutcracker and Wilkie's syndromes is extremely rare but should be considered in patients with evolving abdominal symptoms to avoid unnecessary investigations.
May support conservative weight gain trial in Nutcracker-Wilkie overlap; leaves open efficacy and generalizability beyond single case.
Nutcracker syndrome and Wilkie's syndrome are rare vascular compression disorders that share a common anatomical etiology, a reduced aortomesenteric angle leading to the compression of the left renal vein and the third portion of the duodenum, respectively. The coexistence of both syndromes is extremely rare. We report the case of a 32-year-old female patient with recurrent left flank pain and gastrointestinal symptoms. The initial imaging revealed a compression of the left renal vein consistent with the nutcracker syndrome. Conservative treatment was initiated. Two years later, she developed postprandial epigastric pain and dyspepsia. Further imaging demonstrated a significant narrowing of the aortomesenteric angle, duodenal compression, and gastric dilatation, confirming the coexistence of Wilkie's syndrome. Management remained conservative, with multidisciplinary follow-up. This case emphasizes the importance of considering overlapping vascular compression syndromes in patients with evolving abdominal symptoms. Early recognition is crucial to avoid unnecessary investigations and to optimize clinical outcomes.
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Dulce B Brandão (2025) conducted a case report in Nutcracker Syndrome and Wilkie's Syndrome (n=1). Conservative management was evaluated. Conservative management focusing on weight gain reduced the frequency of abdominal pain and gastrointestinal symptoms in a 32-year-old woman with coexisting Nutcracker and Wilkie's syndromes.
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