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Year : 2013  |  Volume : 29  |  Issue : 1  |  Page : 67-69

Nutcracker phenomenon: An unusual presentation of acute aortic dissection

1 Department of Urology, Toyama City Hospital, Toyama, Japan
2 Department of Emergency, Toyama City Hospital, Toyama, Japan

Correspondence Address:
Koichi Kodama
Department of Urology, Toyama City Hospital, 2-1Imaizumi-hokubucho, Toyama, Toyama 939-8511
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0970-1591.109990

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We report a case of acute aortic dissection leading to compression of the left renal vein (LRV), thereby resulting in the nutcracker phenomenon. A 49-year-old previously healthy woman presented with intermittent gross hematuria and mild left flank pain of five days' duration. Laboratory examinations were within normal limits, except for the elevated C-reactive protein. Cystoscopy revealed bleeding from the left ureteral orifice. Contrast-enhanced computed tomography demonstrated acute Type B aortic dissection and compression of LRV between the enlarged aorta and superior mesenteric artery with an associated dilatation of the left gonadal vein as a collateral circulation.

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