Subject(s)
Arteriovenous Fistula/pathology , Colon/pathology , Embolization, Therapeutic/adverse effects , Mesenteric Artery, Inferior/pathology , Proctocolitis/etiology , Arteriovenous Fistula/complications , Arteriovenous Fistula/diagnostic imaging , Colon/blood supply , Colon/diagnostic imaging , Colonoscopy/methods , Computed Tomography Angiography/methods , Embolization, Therapeutic/methods , Humans , Male , Mesenteric Artery, Inferior/diagnostic imaging , Mesenteric Ischemia/pathology , Mesenteric Veins/diagnostic imaging , Mesenteric Veins/pathology , Proctocolitis/diagnostic imaging , Proctocolitis/pathology , Sigmoidoscopy/methods , Treatment Outcome , Young AdultSubject(s)
Aorta, Abdominal/abnormalities , Aortic Aneurysm, Abdominal/complications , Arteriovenous Fistula/diagnostic imaging , Renal Veins/abnormalities , Tomography, X-Ray Computed , Aorta, Abdominal/diagnostic imaging , Arteriovenous Fistula/etiology , Humans , Male , Middle Aged , Renal Veins/diagnostic imagingABSTRACT
The nutcracker phenomenon is usually caused by compression of the left renal vein by the superior mesenteric artery anteriorly and the aorta posteriorly, although variations of this anatomy have previously been reported. We observed a nutcracker phenomenon in a 42-year-old female who underwent portal venous phase computed tomography of the body for oncologic workup. She had no documented proteinuria or hematuria. Multiplanar reconstructions demonstrated an enhancing left renal vein draining into the left ovarian vein without draining into the inferior vena cava due to external compression immediately before the renocaval junction. The left renal vein was compressed between the right renal artery and the portal vein. This type of nutcracker has not been previously reported in the literature and represents a new variation.
ABSTRACT
After initial treatment, a 54-year-old male with plasma cell leukaemia developed extramedullary relapse in the testis and meninges without evidence of bone marrow involvement. We postulate that the central nervous system (CNS) and testis may have served as sanctuary sites for the disease during initial treatment. A role for CNS prophylaxis in plasma cell leukaemia is suggested.