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Nutcracker Syndrome
The nutcracker syndrome (NCS) results most commonly from the compression of the left renal vein (LRV) between the abdominal aorta (AA) and superior mesenteric artery (SMA), although other variants exist. The name derives from the fact that, in the sagittal plane and/or transverse plane, the SMA and AA (with some imagination) appear to be a nutcracker crushing a nut (the renal vein). There is a wide spectrum of clinical presentations and diagnostic criteria are not well defined, which frequently results in delayed or incorrect diagnosis. The first clinical report of Nutcracker phenomenon appeared in 1950. This condition is not to be confused with superior mesenteric artery syndrome, which is the compression of the third portion of the duodenum by the SMA and the AA. Signs and symptoms The signs and symptoms of NCS are all derived from the outflow obstruction of the left renal vein. The compression causes renal vein hypertension, leading to hematuria (which can lead to anem ...
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Renal Vein
The renal veins in the renal circulation, are large-calibre veins that drain blood filtered by the kidneys into the inferior vena cava. There is one renal vein draining each kidney. Each renal vein is formed by the convergence of the interlobar veins of one kidney. Because the inferior vena cava is on the right half of the body, the left renal vein is longer than the right one. Structure One renal vein drains each kidney. A renal vein is situated anterior to its corresponding accompanying renal artery. The renal veins empty into the inferior vena cava, entering it at nearly a 90° angle. Due to the right-ward displacement of the inferior vena cava from the midline, the left renal vein is some 3 times longer than the right one (~7.5 cm and ~2.5 cm, respectively). The renal vein divides into 4 divisions upon entering the kidney: * the anterior branch which receives blood from the anterior portion of the kidney and, * the posterior branch which receives blood from the posterior ...
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Vomiting
Vomiting (also known as emesis, puking and throwing up) is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose. Vomiting can be the result of ailments like food poisoning, gastroenteritis, pregnancy, motion sickness, or hangover; or it can be an after effect of diseases such as brain tumors, elevated intracranial pressure, or overexposure to ionizing radiation. The feeling that one is about to vomit is called nausea; it often precedes, but does not always lead to vomiting. Impairment due to alcohol or anesthesia can cause inhalation of vomit. In severe cases, where dehydration develops, intravenous fluid may be required. Antiemetics are sometimes necessary to suppress nausea and vomiting. Self-induced vomiting can be a component of an eating disorder such as bulimia nervosa, and is itself now classified as an eating disorder on its own, purging disorder. Complications Aspiration Vomiting is dangerous if gastric content e ...
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Kidney Diseases
Kidney disease, or renal disease, technically referred to as nephropathy, is damage to or disease of a kidney. Nephritis is an inflammatory kidney disease and has several types according to the location of the inflammation. Inflammation can be diagnosed by blood tests. Nephrosis is non-inflammatory kidney disease. Nephritis and nephrosis can give rise to nephritic syndrome and nephrotic syndrome respectively. Kidney disease usually causes a loss of kidney function to some degree and can result in kidney failure, the complete loss of kidney function. Kidney failure is known as the end-stage of kidney disease, where dialysis or a kidney transplant is the only treatment option. Chronic kidney disease is defined as prolonged kidney abnormalities (functional and/or structural in nature) that last for more than three months. Acute kidney disease is now termed acute kidney injury and is marked by the sudden reduction in kidney function over seven days. Rates for both chronic k ...
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Thrombosis
Thrombosis () is the formation of a Thrombus, blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system. When a blood vessel (a vein or an artery) is injured, the body uses platelets (thrombocytes) and fibrin to form a blood clot to prevent blood loss. Even when a blood vessel is not injured, blood clots may form in the body under certain conditions. A clot, or a piece of the clot, that breaks free and begins to travel around the body is known as an embolus. Thrombosis can cause serious conditions such as stroke and heart attack. Thrombosis may occur in veins (venous thrombosis) or in arteries (arterial thrombosis). Venous thrombosis (sometimes called DVT, deep vein thrombosis) leads to a blood clot in the affected part of the body, while arterial thrombosis (and, rarely, severe venous thrombosis) affects the blood supply and leads to damage of the tissue supplied by that artery (ischemia and necrosis). A piece of either an arterial or a v ...
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Left Renal Vein
The renal veins in the renal circulation, are large-calibre veins that drain blood filtered by the kidneys into the inferior vena cava. There is one renal vein draining each kidney. Each renal vein is formed by the convergence of the interlobar veins of one kidney. Because the inferior vena cava is on the right half of the body, the left renal vein is longer than the right one. Structure One renal vein drains each kidney. A renal vein is situated anterior to its corresponding accompanying renal artery. The renal veins empty into the inferior vena cava, entering it at nearly a 90° angle. Due to the right-ward displacement of the inferior vena cava from the midline, the left renal vein is some 3 times longer than the right one (~7.5 cm and ~2.5 cm, respectively). The renal vein divides into 4 divisions upon entering the kidney: * the anterior branch which receives blood from the anterior portion of the kidney and, * the posterior branch which receives blood from the posterior po ...
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ACE Inhibitor
Angiotensin-converting-enzyme inhibitors (ACE inhibitors) are a class of medication used primarily for the treatment of high blood pressure and heart failure. This class of medicine works by causing relaxation of blood vessels as well as a decrease in blood volume, which leads to lower blood pressure and decreased oxygen demand from the heart. ACE inhibitors inhibit the activity of angiotensin-converting enzyme, an important component of the renin–angiotensin system which converts angiotensin I to angiotensin II, and hydrolyses bradykinin. Therefore, ACE inhibitors decrease the formation of angiotensin II, a vasoconstrictor, and increase the level of bradykinin, a peptide vasodilator. This combination is synergistic in lowering blood pressure. As a result of inhibiting the ACE enzyme in the bradykinin system, the ACE inhibitor drugs allow for increased levels of bradykinin which would normally be degraded. Bradykinin produces prostaglandin. This mechanism can explain t ...
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Embolization
Embolization refers to the passage and lodging of an embolus within the bloodstream. It may be of natural origin ( pathological), in which sense it is also called embolism, for example a pulmonary embolism; or it may be artificially induced ( therapeutic), as a hemostatic treatment for bleeding or as a treatment for some types of cancer by deliberately blocking blood vessels to starve the tumor cells. In the cancer management application, the embolus, besides blocking the blood supply to the tumor, also often includes an ingredient to attack the tumor chemically or with irradiation. When it bears a chemotherapy drug, the process is called chemoembolization. Transcatheter arterial chemoembolization (TACE) is the usual form. When the embolus bears a radiopharmaceutical for unsealed source radiotherapy, the process is called radioembolization or selective internal radiation therapy (SIRT). Uses Embolization involves the selective occlusion of blood vessels by purposely ...
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Loin Pain Hematuria Syndrome
Loin pain hematuria syndrome (LPHS) is the combination of debilitating unilateral or bilateral flank pain and microscopic or macroscopic amounts of blood in the urine that is otherwise unexplained. Loin pain-hematuria syndrome (LPHS) is a poorly defined disorder characterized by recurrent or persistent loin (flank) pain and hematuria that appears to represent glomerular bleeding. Most patients present with both manifestations, but some present with loin pain or hematuria alone. Pain episodes are rarely associated with low-grade fever and dysuria, but urinary tract infection is not present. The major causes of flank pain and hematuria, such as nephrolithiasis and blood clot, are typically not present. Renal arteriography may suggest focally impaired cortical perfusion, while renal biopsy may show interstitial fibrosis and arterial sclerosis. The pain is typically severe, and narcotic therapy is often prescribed as a way to manage chronic pain. Sleep can be difficult because the sup ...
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Genitourinary
The genitourinary system, or urogenital system, are the sex organs of the reproductive system and the organs of the urinary system. These are grouped together because of their proximity to each other, their common embryological origin and the use of common pathways. Because of this, the systems are sometimes imaged together. In placental mammals (including humans), the male urethra goes through and opens into the penis while the female urethra and vagina empty through the vulva. The term "apparatus urogenitalis" was used in ''Nomina Anatomica'' (under splanchnologia) but is not used in the current ''Terminologia Anatomica''. Development The urinary and reproductive organs are developed from the intermediate mesoderm. The permanent organs of the adult are preceded by a set of structures that are purely embryonic and that, with the exception of the ducts, disappear almost entirely before the end of fetal life. These embryonic structures are on either side: the pronephros, the ...
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May–Thurner Syndrome
May–Thurner syndrome (MTS), also known as the iliac vein compression syndrome, is a condition in which compression of the common venous outflow tract of the left lower extremity may cause discomfort, swelling, pain or iliofemoral deep vein thrombosis. Specifically, the problem is due to left common iliac vein compression by the overlying right common iliac artery. This leads to stasis of blood, which predisposes to the formation of blood clots. Uncommon variations of MTS have been described, such as the right common iliac vein getting compressed by the right common iliac artery. In the twenty-first century, the May–Thurner syndrome definition has been expanded to a broader disease profile known as nonthrombotic iliac vein lesions (NIVL) which can involve both the right and left iliac veins as well as multiple other named venous segments. This syndrome frequently manifests as pain when the limb is dependent (hanging down the edge of a bed/chair) and/or significant swelling o ...
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Renal Stones
Kidney stone disease (known as nephrolithiasis, renal calculus disease, or urolithiasis) is a crystallopathy and occurs when there are too many minerals in the urine and not enough liquid or hydration. This imbalance causes tiny pieces of crystal to aggregate and form hard masses, or calculi (stones) in the upper urinary tract. Because renal calculi typically form in the kidney, if small enough, they are able to leave the urinary tract via the urine stream. A small calculus may pass without causing symptoms. However, if a stone grows to more than , it can cause blockage of the ureter, resulting in extremely sharp and severe pain (renal colic) in the lower back that often radiates downward to the groin. A calculus may also result in blood in the urine, vomiting (due to severe pain), or painful urination. About half of all people who have had a kidney stone are likely to develop another within ten years. ''Renal'' is Latin for "kidney", while "nephro" is the Greek equivalent. ...
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Pelvic Congestion Syndrome
Pelvic congestion syndrome, also known as pelvic vein incompetence, is a long-term condition believed to be due to enlarged veins in the lower abdomen. The condition may cause chronic pain, such as a constant dull ache, which can be worsened by standing or sex. Pain in the legs or lower back may also occur. While the condition is believed to be due to blood flowing back into pelvic veins as a result of faulty valves in the veins, this hypothesis is not certain. The condition may occur or worsen during pregnancy. The presence of estrogen is believed to be involved in the mechanism. Diagnosis may be supported by ultrasound, CT scan, MRI, or laparoscopy. Early treatment options include medroxyprogesterone or nonsteroidal anti-inflammatory drugs (NSAIDs). Surgery to block the varicose veins may also be done. About 30% of women of reproductive age reporting pelvic pain are affected. It is believed to be the cause of about a third of chronic pelvic pain cases. While pelvic venous ...
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