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  • Title: Diagnosis and successful surgical management of posterior nutcracker syndrome in a patient with loin pain hematuria.
    Author: Syed F, Lam Q, Maharjan N, Portilla D, Smeds MR, Borja-Cacho D.
    Journal: J Ark Med Soc; 2015 May; 111(12):254-6. PubMed ID: 25966600.
    Abstract:
    The syndrome of loin pain hematuria in the absence of stones is poorly understood but must be considered in the differential diagnosis for patients with clinical manifestations resembling nephrolithiasis. A 22-year-old white female with a 4-year history of left flank pain and hematuria underwent an extensive workup with normal renal ultrasound and cystourethroscopies. CT scan and MRI revealed a retro-aortic left renal vein. Posterior nutcracker syndrome was considered the most likely diagnosis. The patient underwent a left laparoscopic nephrectomy with auto-transplantation in the right iliac fossa. She developed azotemia shortly after, which resolved and since then has become asymptomatic.
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