Posterior Nutcracker Syndrome

[AtLASTaDIAGNOSIS]

After 13 long & painful months, I have finally been given a diagnosis of Posterior Nutcracker Syndrome. Over the last 13 months I have been admitted into the Hospital on multiple occasions, suffering from Pyelonephritis. I have had 1 abscess drained on my right kidney, which was the size of an apple and full of Ecoli. My main question is how in the world did I end up with Posterior Nutcracker Syndrome AND could my recent Kidney infections have resulted in this renal vein entrapment situation I seem to be suffering from? Thank you in advance for ANY and ALL help you have to offer.

[AtLASTaDIAGNOSIS]

Hi Dr. Santos,

Thank you for the reply! I am trying to gather as much information as possible, as my Doctor is on vacation all week. I received his phone call Friday afternoon and then he left on vacation. I am currently being seen by an Infectious Disease Doctor, Urologist, Nephrologist and our Family Doctor. Is Nutcracker Syndrome difficult to diagnose? I have had numerous CT Scans, MRI's, Ultrasounds and X-Rays over the last 13 months and it wasn't until my ER visit last week that my Urologist noticed this issue with my left kidney. I guess I'm just trying to understand the whole process.

Thank you kindly for your help!

[Dr Santos]

Hi,
How are you?  The posterior nutcracker syndrome  is usually considered when the left renal vein is compressed between the aorta and vertebral column. This may present with symptoms such as intermittent left flank pain associated with hematuria, proteinuria, and sometimes with symptoms of pelvic congestion. Being a rare condition, diagnosis is often difficult and plan for treatment usually requires careful evaluation of the diagnostic tests as well as medical history of patient. The cause is not fully understood but renal anomalies or varicosities or abnormal branching of the superior mesenteric artery from the aorta are the most common factors and may be the cause of the infections. It is best that you discuss this also with your attending physician for proper evaluation. Take care and best regards.