Nutcracker Syndrome and Left Renal Vein Entrapment

Overview

4.2 out of 5 (10 Reviews)

Credits

1.00

Post Assessment Questions

12

Start Date

1 Sep 2023

Last Review Date

5 Mar 2024

Expiration Date

31 Aug 2026

Estimated Time To Finish

60 Minutes


 
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Activity Description

Nutcracker syndrome, or left renal vein entrapment, describes an uncommon condition involving compression of the left renal vein, usually between the aorta and the superior mesenteric artery. While uncommon, nutcracker syndrome is likely underdiagnosed and can lead to severe complications if left untreated. Symptoms of nutcracker syndrome in all age groups can include intermittent gross or microscopic hematuria, flank pain, orthostatic proteinuria, varices, and autonomic dysfunction. Women may develop pelvic congestion syndrome, dyspareunia, or dysmenorrhea, and men may have left-sided varicoceles; nutcracker syndrome may contribute to infertility in both sexes.

Diagnosing nutcracker syndrome can be difficult; a high index of suspicion is required. Nutcracker syndrome is predominately a clinical diagnosis confirmed by imaging studies to document the characteristic left renal vein compression. While a course of conservative treatment is recommended for all patients regardless of age, most adults with nutcracker syndrome will eventually require an interventional procedure to achieve symptom relief. Treatment is pharmacologic in the pediatric age group but is generally procedural in symptomatic adults. This activity reviews the etiology, epidemiology, pathophysiology, typical clinical presentation, evaluation, and management of nutcracker syndrome and emphasizes the role of the interprofessional team in caring for patients with this condition.


Target Audience

This activity has been designed to meet the educational needs of physicians, physician associates, nurses, pharmacists, and nurse practitioners.

Learning Objectives

At the conclusion of this activity, the learner will be better able to:

  • Correlate the pathophysiology of nutcracker syndrome with the common clinical findings.

  • Determine the most appropriate diagnostic methods to employ when evaluating a patient with suspected nutcracker syndrome.

  • Select the most efficacious therapeutic intervention for a patient with nutcracker syndrome.

  • Develop and implement effective interprofessional team strategies to improve outcomes for patients with nutcracker syndrome.

Disclosures

StatPearls, LLC requires everyone who influences the content of an educational activity to disclose relevant financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. All relevant conflict(s) of interest have been mitigated. Hover over contributor names for financial disclosures. Others involved in planning this educational activity have no relevant financial relationships to disclose.

Commercial Support: This activity has received NO commercial support.

Continuing Education Accreditation Information

In support of improving patient care, StatPearls, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

 

Physicians and Physician Associates: StatPearls, LLC designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit(s)TM. Physicians and PAs should only claim credit commensurate with the extent of their participation in the activity.

American Board of Internal Medicine: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

American Board of Pathology: Successful completion of this Continuing Certification activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 Lifelong Learning (CME) credits in the American Board of Pathology’s Continuing Certification Program.

American Board of Pediatrics: Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn up to 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit learner completion information to ACCME for the purpose of granting ABP MOC credit.

American Board of Surgery: Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn credit toward the CME and Self-Assessment requirement(s) of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.

Royal College of Physicians and Surgeons of Canada: Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME’s “CME in Support of MOC” program in Section 3 of the Royal College’s MOC Program.

Please consult your professional licensing board for information on the applicability and acceptance of continuing education credit for this activity.

Method of Participation and Credit

  1. Register for the activity.    
  2. Review the target audience, learning objectives, and disclosure information.
  3. Study the educational content of the enduring material.
  4. Choose the best answer to each activity test question. To receive credit and a certificate, you must pass the test questions with a minimum score of 100%.
  5. Complete the post-activity assessment survey.

If you have concerns regarding the CE/CME system, please contact support@statpearls.com.

Disclaimer

This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Faculty may discuss investigational products or off-label uses of products regulated by the FDA. Readers should verify all information before employing any therapies described in this educational activity.

The information provided for this activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition. The information presented does not necessarily reflect the views of StatPearls or any commercial supporters of educational activities on statpearls.com. StatPearls expressly disclaims responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through a participant's misunderstanding of the content.

Unapproved Uses of Drugs/Devices: In accordance with FDA requirements, the audience is advised that information presented in this continuing education activity may contain references to unlabeled or unapproved uses of drugs or devices. Please refer to the FDA-approved package insert for each drug/device for full prescribing/utilization information.

Cancellation Policy: Please see the cancellation policy. StatPearls, LLC reserves the right to cancel any course due to unforeseen circumstances.

 

 
 

Reviews

Jason H. on 9/23/2021

Hardeep A. on 9/28/2022

Michael C. on 7/20/2023

Robert S. on 7/31/2023

David c. on 9/15/2023

Nikhil K. on 10/2/2023

Richard F. on 10/22/2023

Kenneth W. on 10/23/2023

Nelson M. on 1/29/2024

Jonathan K. on 3/8/2024

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