nut-cracker case
July 14, 2020

Thanks to dr.Amira Baredhwan for her amazing presentation 

Case:

15 years old female patient, medically free, presented with chronic recurrent history of abdominal pain , that is variable in severity , requiring sometimes hospital admission , she underwent both upper and lower scope with no definite diagnosis, what would be your approach ? DDx ? and how would you manage ?

Approach:

you will approach the patient based on patient stability, looking for red flags, and ruling out serious causes ,then looking for ddx of abdominal pain

findings:

this patient was admitted under gastro team , CT abdomen was done and showed that she has no evidence of demoniacal pain , however found to have anterior nut-cracker syndrome

NUTCRACKER-SYNDROME-NEW

key points:

  • anterior nutcracker phenomena = findings without symptoms , while anterior nutcracker syndrome = findings with symptoms
  • nutcracker syndrome can be congenital or acquired especially post spinal surgeries, significant weight loss.
  • medical treatment including encouraging weight gain