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Nascer e Crescer
versión impresa ISSN 0872-0754versión On-line ISSN 2183-9417
Resumen
MARTINS, Andreia A. et al. Nephro urology case. Nascer e Crescer [online]. 2018, vol.27, n.2, pp.133-136. ISSN 0872-0754.
The Nutcracker Syndrome (NS) originates from the compression of the left renal vein in its trajectory, mostly between the aorta and the superior mesenteric artery, or less frequently between the aorta and the lumbar spine. Although asymptomatic in most cases, it can be a rare cause of hematuria. We present the case of an 11-year-old male adolescent who was referred to a Pediatric Nephrology evaluation for a two-month-long gross hematuria. The patient also had anemia without hemodynamic repercussion. After the initial work-up, it was concluded to be a non-glomerular, extra-renal hematuria. Abdominal and renal ultrasound with Doppler was normal. The abdominal and pelvic computerized angiotomography revealed, after a careful examination, the presence of NS. Due to persistent gross hematuria with the need for transfusional support, at the age 13, the patient underwent a renal autotransplantation. The diagnosis of NS is essentially clinical, imagiological and necessarily a diagnosis of exclusion. The treatment must be individualized and requires a multifactorial approach.
Palabras clave : Hematuria; Nutcracker syndrome.