Side pain, hematuria due to rare 'nutcracker' syndrome

Mr. Nam had left flank pain, blood in his urine, and examination revealed varicocele due to the rare 'nutcracker' syndrome, with a rate of 3-4/100,000.

One day after surgery to treat congenital "nutcracker" syndrome, Mr. Ho Nam (21 years old, Tan Phu district, Ho Chi Minh City) no longer has flank pain, the varicose veins on the testicles have disappeared. The patient received timely intervention to avoid complications of renal vein thrombosis, kidney damage, infertility...

Before that, Mr. Nam had a dull pain in the left rib area, mixed with blood in the urine. When examined at Tam Anh Hospital, the doctor noticed prominent veins on the left testicle, diagnosing varicocele due to the patient suffering from "nutcracker" syndrome. Specifically, the renal vein was clamped by the aorta and superior mesenteric artery, preventing blood from flowing to the inferior vena cava. Gradually, blood stagnated in the left testicle, causing varicocele.

Dr. Nguyen Anh Dung, Head of the Department of Cardiovascular and Thoracic Surgery, Cardiovascular Center, Tam Anh General Hospital, Ho Chi Minh City, said that patients with "nutcracker" syndrome need to have a stent placed or surgery to reopen the blood flow from the kidney to the heart. However, in this case, even though the narrowed blood vessel can be dilated, the stent can drift away because the blood vessel will dilate over time. Therefore, the doctor decided to perform renal vein transfer surgery.

The doctor cut the compressed renal vein and attached it to the inferior vena cava, creating a new pathway for blood to flow from the kidney to the heart. Two days after the surgery, Mr. Nam's symptoms completely improved and he was discharged from the hospital.

Surgeons created a new path for blood from the kidney to the heart, freeing the compressed renal vein. Photo: Tam Anh Hospital — Surgeons created a new path for blood from the kidney to the heart, freeing the compressed renal vein. Photo: *Tam Anh Hospital*

Dr. Tran Quoc Hoai, Cardiovascular Center, Tam Anh General Hospital, Ho Chi Minh City, explained that the two kidneys perform important functions in the body such as: removing waste from the blood, balancing body fluids, creating urine... Each kidney has a vein that carries blood from the kidney to the heart, called the renal vein. In nutcracker syndrome, the left renal vein is compressed and blood cannot circulate normally through this vein. Instead, blood flows back into other veins and causes them to swell. In some cases, blood stagnates in the testicles, causing varicocele, as in the case of patient Nam.

Nutcracker syndrome can occur at any age. Some studies show that the disease is more common in adolescents and young people in their 20s and 30s. The disease cannot be prevented, but early detection and timely intervention will help prevent serious complications. "If you see symptoms of blood in the urine, pelvic pain, abdominal pain or pain in one side, pain during sex, dizziness when standing, prominent veins in the testicles... you need to see a doctor immediately," Dr. Hoai emphasized.

Thu Ha

* The names of the characters in the article have been changed.

Source link