Key result
Conservative management successfully treats Nutcracker syndrome presenting with intermittent flank and abdominal pain.
Why the study?
Nutcracker syndrome is an uncommon and often undiagnosed cause of abdominal and flank pain in children with variable clinical manifestations and management approaches.
Case Report (n=1)
Nutcracker syndrome should be considered in the differential diagnosis for children presenting with abdominal and flank pain.
Conservative management may be appropriate in select pediatric Nutcracker cases; leaves open optimal strategies pending larger prospective studies.
The nutcracker phenomenon is characterized by compression of the left renal vein typically between the abdominal aorta and superior mesenteric artery. It is an uncommon and often undiagnosed condition that has the potential to cause a range of symptoms including hematuria and abdominal or flank pain. The term nutcracker syndrome refers to the clinical manifestations of the nutcracker phenomenon. Diagnosis can be made with Doppler ultrasound, computed tomography angiography, magnetic resonance angiography, or venography. Management can range from conservative treatment in the pediatric population due to high spontaneous remission rate to surgical and endovascular interventions. We discuss the case of a previously healthy young female who presented with abdominal pain. Diagnosis of nutcracker syndrome was made based on imaging. The patient was managed conservatively. This case highlights the importance of considering nutcracker syndrome in the differential diagnosis when evaluating patients with abdominal and flank pain.
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Agarwal et al. (2021) conducted a case report in Nutcracker Syndrome (n=1). Conservative management was evaluated. A 13-year-old female presenting with intermittent left-sided flank and abdominal pain was diagnosed with Nutcracker syndrome via imaging and managed conservatively.
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