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Case report
Nutcracker syndrome complicated with intestinal malrotation
  1. Yosuke Nishio,
  2. Yoshihiko Kawano and
  3. Shinya Hara
  1. Pediatrics, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
  1. Correspondence to Dr Yosuke Nishio; y.nishio1989{at}


Nutcracker syndrome (NCS) is a pathological condition in which the left renal vein (LRV) is compressed between the superior mesenteric artery (SMA) and aorta. NCS can predispose patients to the onset of chronic kidney disease because of persistent increase in LRV pressure. Although NCS in children is often idiopathic, it can also be caused by underlying pathologies such as retroperitoneal tumours. To the best of our knowledge, there have been no reports regarding paediatric cases of NCS complicated with intestinal malrotation. Here, we report the case of a 12-year-old girl with intestinal malrotation complicated with NCS whose haematuria resolved after surgical intervention for intestinal malrotation. The present case findings indicate that intestinal malrotation with concomitant weight loss is a potential underlying aetiology in NCS. Thus, when NCS is especially diagnosed with gastrointestinal symptoms, intestinal malrotation should be considered as an underlying aetiology.

  • gastrointestinal surgery
  • haematuria
  • paediatrics
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  • Contributors YN gathered data regarding the case, performed a detailed literature search, drafted the initial manuscript and revised the manuscript. YK and SH supervised the data, literature review and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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