Atnalı böbrekte nutcracker sendromu beklenen bir vasküler anomali midir?

Abstract

Purpose: Horseshoe kidney is the most common fusion anomaly that congenital systemic and urological anomalies accompany most of the patients. In this study, we aimed to investigate its association with vascular anomalies and especially nutcracker syndrome along with accompanying urological and other systemic anomalies in children with horseshoe kidney. 
 Materials and methods: Twenty-six patients are diagnosed with horseshoe kidney in our clinic and 22 healthy children of the same age and sex were included in the study. All children were prospectively evaluated using Doppler ultrasonography in terms of renal artery and renal vein flow velocities, lumen diameters and vascular anomalies and presence of nutcracker syndrome. 
 Results: Urological anomaly was found in 50% of the children with horseshoe kidneys, and systemic anomaly in 44% of them. In Doppler ultrasonographic evaluations performed on patients to detect vascular pathologies and nutcracker syndrome; findings of nutcracker syndrome were present in 2 patients in the horseshoe kidney group, while they were detected incidentally in 1 patient in the control group. An accessory renal artery originating from the left common iliac artery was found in a case with horseshoe kidney, and a circumaortic left renal vein in one case. 
 Conclusions: In our study in which we investigated nutcracker syndrome based on the presence of vascular anomalies accompanying horseshoe kidneys in children, nutcracker syndrome findings were found in similar numbers in both groups. However, we think that these children should be followed for a long time in terms of vascular pathologies (aneurysm, rupture) and malignancies that may occur in adulthood, as well as congenital vascular anomalies.