case_images: PMC10111633_01
case_images: Computed tomography (CT) scans of a 24-year-old woman with trauma-associated left renal vein thrombosis with nutcracker syndrome. (A) Enhanced CT of the abdomen showing a dilated left renal vein (LRV), compressed between the superior mesenteric artery and the abdominal aorta (yellow arrowhead). (B) Enhanced CT of the abdomen showing a solitary LRV thrombus (yellow arrow), not present at the time of admission, formed during the course of treatment.
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case_images: PMC10111633_01_AMS2-10-e838-g003.jpg
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case_images: LRV, suggesting blood flow stagnation, called beak sign; however, no thrombus was found (Fig. 1A). Laboratory findings on admission were as follows: leukocytes 16,900/muL, hemoglobin 11.6 g/dL, platelets 214,000/muL, activated partial thromboplastin time 21.7 s, prothrombin time (international normalized ratio) 1.07, fibrinogen 246.0 mg/dL, and D-dimer 52.0 mug/dL. CT was performed again to detect the presence of a thrombus preoperatively. Computed tomography revealed a solitary LRV thrombus that was not noted on the prior CT (Fig. 1); there were no physical complaints, such as left flank pain.
case_images: Computed tomography scan of a 24-year-old woman with trauma-associated left renal vein thrombosis with nutcracker syndrome. The sagittal section shows the angle between the superior mesenteric artery and abdominal aorta, which had narrowed to 25 .
case_images: AMS2-10-e838-g001.jpg
case_images: PMC10111633_01_AMS2-10-e838-g001.jpg
case_images: ams2838-fig-0002
case_images: Furthermore, the angle between the SMA and abdominal aorta in the sagittal section narrowed to 25  (Fig. 2), which is usually greater than 35 , revealing NCS with beak sign (Fig. 1).