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The nutcracker syndrome results from compression of the left renal vein between the aorta and the superior mesenteric artery. The nutcracker syndrome ( NCS ) results most commonly from the compression of the left renal vein (LRV) between the abdominal aorta (AA) and superior mesenteric artery (SMA), although other variants exist.
SMA syndrome is also known as Wilkie's syndrome, cast syndrome, mesenteric root syndrome, chronic duodenal ileus and intermittent arterio-mesenteric occlusion. [3] It is distinct from nutcracker syndrome , which is the entrapment of the left renal vein between the AA and the SMA, although it is possible to be diagnosed with both conditions.
Acute occlusion of the SMA almost invariably leads to intestinal ischemia and often has devastating consequences, with up to 80% of SMA occlusions leading to death. [2] The SMA can compress the left renal vein, leading to nutcracker syndrome; and/or the third (horizontal) part of the duodenum, leading to superior mesenteric artery syndrome.
Median arcuate ligament syndrome is a diagnosis of exclusion. [ 2 ] [ 5 ] That is, the diagnosis of MALS is generally considered only after patients have undergone an extensive evaluation of their gastrointestinal tract including upper endoscopy , colonoscopy , and evaluation for gallbladder disease and gastroesophageal reflux disease (GERD).
It passes through the angle formed by the abdominal aorta (situated posteriorly), and superior mesenteric artery (situated anteriorly) (increased acuteness of this angle may lead to the left renal vein being "pinched" between the two arteries, with the resulting compression impairng blood flow through the vein, a condition known as nutcracker ...
SMA syndrome is also known as Wilkie's syndrome, cast syndrome, mesenteric root syndrome, chronic duodenal ileus and intermittent arterio-mesenteric occlusion. [6] It is distinct from Nutcracker syndrome , which is the entrapment of the left renal vein between the AA and the SMA, although it is possible to be diagnosed with both conditions [ 7 ] .
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