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Double nutcracker syndrome in a patient with circumaortic venous ring: a rare case report Cover

Double nutcracker syndrome in a patient with circumaortic venous ring: a rare case report

Journal of Ultrasonography
Volume 23 (2023): Issue 93 (June 2023)
By: Renato Farina,  Pietro Valerio Foti,  Lorena Nicolosi and  Antonio Basile  
Open Access
|May 2023

Figures & Tables

Fig. 1.

Diagram showing the anatomical relationships in a patient with NCS. Ao – abdominal aorta
Diagram showing the anatomical relationships in a patient with NCS. Ao – abdominal aorta

Fig. 2.

CT of double NCS. A. In this image, the retroaortic renal vein (arrow) appears compressed between the aorta and spine. ICV: Inferior cava vein. B. This image shows the anteroaortic renal vein (short arrow) which appears compressed in the space between the aorta and superior mesenteric artery (long arrow). C. This coronal view shows gonadal vein dilatation (arrow). d: This axial view shows varicosities of the gonadal plexus (arrows)
CT of double NCS. A. In this image, the retroaortic renal vein (arrow) appears compressed between the aorta and spine. ICV: Inferior cava vein. B. This image shows the anteroaortic renal vein (short arrow) which appears compressed in the space between the aorta and superior mesenteric artery (long arrow). C. This coronal view shows gonadal vein dilatation (arrow). d: This axial view shows varicosities of the gonadal plexus (arrows)

Fig. 3.

Grayscale US of the abdominal aorta. Measurement of aortomesenteric distance and aortomesenteric angle. A. Transverse scan of the abdominal aorta shows a narrowing of the aortomesenteric space (D1) measuring 4.2 mm. Superior mesenteric artery (arrow head). Left anteroaortic renal vein (short arrow). Left retroaortic renal vein (long arrow). Abdominal aorta (Ao). Inferior cava vein (ICV). B. Longitudinal scan of the abdominal aorta shows a narrowing of the aortomesenteric angle (18°) and aortomesenteric distance (D1) measuring 4.2 mm. C. Pelvic ultrasound scans show gonadal plexus varicosities (arrows). D. Color Doppler US shows prestenotic tract of the retroaortic renal vein (short arrow) and poststenotic tract of the anteroaortic renal vein (long arrow). Ao: Abdominal aorta. E. Duplex Doppler US measure of the prestenotic flow of retroaortic renal vein. F. Duplex Doppler US measure of the poststenotic flow of retroaortic renal vein
Grayscale US of the abdominal aorta. Measurement of aortomesenteric distance and aortomesenteric angle. A. Transverse scan of the abdominal aorta shows a narrowing of the aortomesenteric space (D1) measuring 4.2 mm. Superior mesenteric artery (arrow head). Left anteroaortic renal vein (short arrow). Left retroaortic renal vein (long arrow). Abdominal aorta (Ao). Inferior cava vein (ICV). B. Longitudinal scan of the abdominal aorta shows a narrowing of the aortomesenteric angle (18°) and aortomesenteric distance (D1) measuring 4.2 mm. C. Pelvic ultrasound scans show gonadal plexus varicosities (arrows). D. Color Doppler US shows prestenotic tract of the retroaortic renal vein (short arrow) and poststenotic tract of the anteroaortic renal vein (long arrow). Ao: Abdominal aorta. E. Duplex Doppler US measure of the prestenotic flow of retroaortic renal vein. F. Duplex Doppler US measure of the poststenotic flow of retroaortic renal vein

Summary of results obtained by Doppler US

Flow ratioPrestenotic PSVPoststenotic PSVFlow ratio after 1 month
Anterior LRV2.6918.8 cm/s50.6 cm/s2.4
Posterior LRV2.758 cm/s22 cm/s2.75
DOI: https://doi.org/10.15557/jou.2023.0018 | Journal eISSN: 2451-070X | Journal ISSN: 2084-8404
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Language: English
Page range: e101 - e105
Submitted on: Oct 13, 2022
Accepted on: Mar 16, 2023
Published on: May 11, 2023
Published by: MEDICAL COMMUNICATIONS Sp. z o.o.
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
nutcracker syndrome,
ultrasound,
cardiovascular abnormalities,
computed tomography,
magnetic resonance imaging
Related subjects:
Medicine,
Basic medical science,
Basic medical science, other

© 2023 Renato Farina, Pietro Valerio Foti, Lorena Nicolosi, Antonio Basile, published by MEDICAL COMMUNICATIONS Sp. z o.o.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

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