case_images: PMC11290811_01
case_images: Image of superior mesenteric artery syndrome and two images of renal vein entrapment syndrome. (A) Contrast is not easily passing through into the second and third portion of duodenum. The third portion the duodenum does appear narrowed as it extends under the superior mesenteric artery (SMA). (B) This axial CT image shows atypical venous drainage of the left kidney with appearance of a nutcracker syndrome. In this view, the renal vein to the left of the SMA appears dilated measuring up to 9 mm. The renal vein more medial to the SMA is thin and strand-like measuring 2 mm. This could be a hemodynamically significant stenosis. (C) This CT coronal slice is another view of nutcracker syndrome evident in the patient.
case_images: goae079f1.jpg
case_images: PMC11290811_01_goae079f1.jpg
case_images: goae079-F1
case_images: There was distension of the stomach and duodenum to the level of the SMA, indicative of SMA syndrome as seen in Figure 1A. CT incidentally revealed a coexisting nutcracker phenomenon, the extrinsic compression of the left renal vein by the SMA anteriorly (Figure 1B and C).