Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

22 April 2020 : Case report  Italy

A Case of Nutcracker Syndrome Combined with Wilkie Syndrome with Unusual Clinical Presentation

Unusual clinical course, Challenging differential diagnosis, Diagnostic / therapeutic accidents, Management of emergency care, Rare disease, Congenital defects / diseases, Clinical situation which can not be reproduced for ethical reasons, Rare coexistence of disease or pathology

Renato Farina1ABCDE*, Francesco Aldo Iannace1BE, Pietro Valerio Foti1ABE, Andrea Conti1BE, Corrado Inì1BE, Federica Libra1BE, Luigi Fanzone1BE, Maria Enza Coronella1B, Serafino Santonocito1BEF, Antonio Basile1BE

DOI: 10.12659/AJCR.922715

Am J Case Rep 2020; 21:e922715

Abstract

BACKGROUND: Nutcracker syndrome and Wilkie’s syndrome are rare vascular diseases due to the abnormal course of the superior mesenteric artery originating from the abdominal aorta with reduced angle (<22°) and consequent compression of the left renal vein (nutcracker) and duodenum (Wilkie). Here, we report the case of a patient with a rare combination of these 2 syndromes and with unusual clinical manifestation of post-prandial pain.

CASE REPORT: We describe the case of a young male patient with rapid weight loss, coupled with post-prandial abdominal pain, with sub-acute onset, not associated with other symptoms. The ultrasound examination found an aorto-mesenteric angle of 18° and compression of the left renal vein and left varicocele. A CT study was performed to exclude oncological diseases and/or other pathologies responsible for the pain and weight loss, which confirmed the ultrasound findings and showed compression of the third part of the duodenum. The patient underwent endovascular treatment, with stent placement in the left renal vein, which resolved the vascular compression and of the duodenum, with regression of symptoms.

CONCLUSIONS: The ultrasound scan promptly highlighted the reduction of the aorto-mesenteric angle and the signs of venous congestion of the left renal vein. Based on this experience, in patients with weight loss and post-prandial pain, in our opinion, diagnostic investigations should also be extended to the study of the aorto-mesenteric angle to confirm or exclude any vascular and/or duodenal compression.

Keywords: Mesenteric Artery, Superior, Renal Nutcracker Syndrome, Superior Mesenteric Artery Syndrome, Ultrasonography, Doppler, Color, Abdominal Pain, Comorbidity, Duodenum, endovascular procedures, Renal Veins

Add Comment 0 Comments

In Press

06 Mar 2024 : Case report  Saudi Arabia

Successful Healing of Periapical Pathology with Partial Pulpotomy in a Mature Permanent Molar: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.942937  

0:00

12 Mar 2024 : Case report  Japan

Successful Treatment of Lithium-Induced Nephrogenic Diabetes Insipidus with Celecoxib: A Promising Therapeu...

Am J Case Rep In Press; DOI: 10.12659/AJCR.943244  

0:00

13 Mar 2024 : Case report  Taiwan

Recurrent Marginal Zone Lymphoma with Bone Marrow Involvement Detected by ¹⁸F-FDG PET/CT and Biopsy: A Diag...

Am J Case Rep In Press; DOI: 10.12659/AJCR.943275  

13 Mar 2024 : Case report  Denmark

Unveiling the Temporal Aspect of MRI Tattoo Reactions: A Prospective Evaluation of a Newly-Acquired Tattoo ...

Am J Case Rep In Press; DOI: 10.12659/AJCR.943411  

Most Viewed Current Articles

07 Mar 2024 : Case report  USA

Neurocysticercosis Presenting as Migraine in the United States

DOI :10.12659/AJCR.943133

Am J Case Rep 2024; 25:e943133

0:00

10 Jan 2022 : Case report  Germany

A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...

DOI :10.12659/AJCR.935263

Am J Case Rep 2022; 23:e935263

19 Jul 2022 : Case report  Saudi Arabia

Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19

DOI :10.12659/AJCR.936128

Am J Case Rep 2022; 23:e936128

23 Feb 2022 : Case report  USA

Penile Necrosis Associated with Local Intravenous Injection of Cocaine

DOI :10.12659/AJCR.935250

Am J Case Rep 2022; 23:e935250

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923