Nutcracker syndrome: A proposed ultrasound protocol

Abstract

Background: Nutcracker phenomenon (NCP) describes the compression of the left renal vein between the aorta and the superior mesenteric artery. Nutcracker Syndrome (NCS) refers to the clinical manifestations of NCP. Aims: This paper aims to provide education and ultrasound protocol for Clinicians and Sonographers who encounter patients with the symptoms of NCS during their course of practice. Methods: The following report examines two case studies where a diagnosis of NCP was made from clinical history and ultrasound findings. Based on these case studies, we would like to propose an appropriate ultrasound scanning protocol for patients presenting with symptoms of gonadal vein incompetence. Results: The above case studies highlight the need for further assessment with ultrasound to help diagnose cases of NCP. Conclusion: The proposed ultrasound techniques are a valid protocol extension to the ultrasound examination to help diagnose NCP.