Nutcracker syndrome, or left renal vein entrapment, describes an uncommon condition involving compression of the left renal vein, usually between the aorta and the superior mesenteric artery. While uncommon, nutcracker syndrome is likely underdiagnosed and can lead to severe complications if left untreated.Symptoms of nutcracker syndrome in all age groups can include intermittent gross or microscopic hematuria, flank pain, orthostatic proteinuria, varices, and autonomic dysfunction. Women may develop pelvic congestion syndrome, dyspareunia, or dysmenorrhea, and men may have left-sided varicoceles; nutcracker syndrome may contribute to infertility in both sexes.Diagnosing nutcracker syndrome can be difficult, and a high index of suspicion is required. This is predominantly a clinical diagnosis confirmed by imaging studies that document the characteristic left renal vein compression. While a course of conservative treatment is recommended for all patients regardless of age, most adults with nutcracker syndrome will eventually require an interventional procedure to achieve symptom relief. Treatment is pharmacologic in the pediatric age group but is generally procedural in symptomatic adults.This activity reviews the etiology, epidemiology, pathophysiology, typical clinical presentation, evaluation, and management of nutcracker syndrome and emphasizes the role of the interprofessional team in caring for patients with this condition.
- Provider:StatPearls, LLC
- Activity Link: https://www.statpearls.com/ArticleLibrary/viewarticle/97965
- Start Date: 2023-09-01 05:00:00
- End Date: 2023-09-01 05:00:00
- Credit Details: AMA PRA Category 1 Credit™️: 1.0 hours
Nursing: 1.0 hours
Pharmacy: 1.0 hours - MOC Credit Details: ABS - 1.0 Point; Credit Type(s): Accredited CME (ABS)
ABPATH - 1.0 Point; Credit Type(s): Lifelong Learning (ABPATH)
ABTS - 1.0 Point; Credit Type(s): Accredited CME (ABTS)
ABIM - 1.0 Point; Credit Type(s): Medical Knowledge (ABIM)
ABS - 1.0 Point; Credit Type(s): Self-Assessment (ABS)
ABP - 1.0 Point; Credit Type(s): Lifelong Learning and Self-Assessment (ABP)
ABTS - 1.0 Point; Credit Type(s): Self-Assessment (ABTS) - Commercial Support: No
- Activity Type: Enduring Material
- CME Finder Type: Online Learning
- Fee to Participate: Variable
- Measured Outcome: Learner Knowledge, Learner/Team Competence
- Provider Ship: Directly Provided
- Registration: Open to all
- Specialty: Adolescent Medicine, Cardiovascular, General Pediatrics, General Surgery, Internal Medicine, Nephrology, Non-Thoracic Surgery, Pediatric Nephrology, Renal/Medical Renal, Vascular Surgery