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Nutcracker syndrome associated with celiacomesentric trunk anomaly: case report

Authors Al-Zoubi NA, Al-Ghalayini IF, Al-Okour R

Received 19 July 2017

Accepted for publication 11 November 2017

Published 13 December 2017 Volume 2017:10 Pages 285—288


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Pravin Singhal

Nabil A Al-Zoubi,1 Ibrahim F Al-Ghalayini,1,2 Radwan Al-Okour1,2

1Department of Surgery, 2Division of Urology, Jordan University of Science and Technology, Irbid, Jordan

Introduction: Nutcracker syndrome is a rare disease entity that is caused by entrapment of the left renal vein between the aorta and superior mesenteric artery, usually due to abnormal branching of the superior mesenteric artery from the aorta causing renal venous hypertension. The symptoms vary from asymptomatic hematuria to severe pelvic congestion. Celiacomesenteric trunk anomaly is a rare variation of splanchnic artery anomaly that occurs when the celiac trunk and superior mesenteric arteries have a common origin from the aorta. A disease involving the rarely encountered celiacomesenteric trunk anomaly is extremely uncommon. To our knowledge, association between nutcracker syndrome and celiacomesentric trunk anomaly has not been reported in the literature.
Case presentation: A 14-year-old boy with no significant past medical history presented with a 3-year painless hematuria. CT-angiogram revealed anterior nutcracker syndrome with celiacomesenteric trunk anomaly. The patient was managed conservatively with close follow-up.
Conclusion: Nutcracker syndrome associated with celiacomesenteric trunk anomaly is extremely uncommon and is a rare cause of hematuria in children. Whether this abnormal anatomy is the cause of nutcracker syndrome or just an association should be investigated. Moreover, awareness of this anatomical variation may help in planning therapeutic options and reducing the chance of surgical iatrogenic injuries.

Keywords: nutcracker syndrome, celiacomesenteric trunk, hematuria in children

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