Main description:

The nutcracker phenomenon (NCP) is an accentuated phenomenon of normal subtle compression of the left renal vein (LRV) between the abdominal aorta and superior mesenteric artery. The nutcracker syndrome (NCS) is a syndrome caused by NCP, resulting in hematuria, proteinuria, or left flank pain.

The established diagnostic criterion of NCP is a pressure gradient more than 3 mmHG across the compression site, and NCS has been known to be rare, but probably is not rare and in fact quite common. The most important reason why NCS is known to be rare is that the diagnosis is difficult unless invasive venous catheterization and pressure measurement confirm the pressure gradient. Doppler ultrasound is useful in measuring the flow velocity of LRV. From the velocity measured by Doppler ultrasound, we may estimate the pressure gradient. Doppler ultrasound of LRV needs technical skills and experience. Computed tomography (CT) is a popular imaging technique for patients with hematuria, and we need to be familiar with the findings of the NCP at CT. There are variations of NCP associated with vascular anatomy and posture of the patients. This book will illustrate the concepts of NCP and NCS, findings at Doppler ultrasound and CT, and variations of NCP.

Contents:

Chapter_01_Introduction

Chapter_02_Nutcracker Phenomenon (NCP) and Nutcracker Syndrome (NCS)

Chapter_03_Prevalence of NCP and NCS

Chapter_04_Left Renal Vein (LRV)

Chapter_05_Diagnostic Techniques and Criteria

Chapter_06_Doppler Ultrasound

Chapter_07_CT and MRI Findings

Chapter_08_Subtypes of NCP and NCS

Chapter_09_NCP associated with Congenital Variations of LRV and IVC

Chapter_10_Postural Variations of NCP and NCS

Chapter_11_Other Variations of NCP and NCS

Chapter_12_Severe NCP, Occlusion of LRV

Chapter_13_NCP and NCS in Members of the Same Family

Chapter_14_ NCP-related or associated diseases

Chapter_15_Management of NCS

Chapter 16_Asymptomatic hematuria and proteinuria