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 Jan 2021

Last Review Date

5 Mar 2024

Expiration Date

31 Dec 2023

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.

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

The Campbell University Jerry M. Wallace School of Osteopathic Medicine (CUSOM) requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they or their immediate family may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by CUSOM for resolution, to ensure fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

CUSOM will identify, review, and resolve all conflicts of interest that faculty, authors, activity directors, planners, managers, peer reviewers, or relevant staff disclose prior to an educational activity being delivered to learners. Disclosure of a relationship is not intended to suggest or condone bias in any presentation but is made to provide participants with information that might be of potential importance to their evaluation of a presentation. Disclosure information for authors, editors, planners, peer reviewers, and/or relevant staff is provided with this activity.

Continuing Education Accreditation Information

 

 

The Campbell University Jerry M. Wallace School of Osteopathic Medicine (CUSOM) is accredited by the American Osteopathic Association to provide osteopathic continuing medical education for physicians. CUSOM designates this enduring material for a maximum of 1.00 AOA Category 1 B Credits and will report CME credits commensurate with the extent of the physician's participation in the activity.

Cancellation Policy: Cancellations must be received in writing and a money back guarantee is provided if not completely satisfied.

  • StatPearls and CUSOM reserve the right to cancel any course due to unforeseen circumstances. StatPearls and CUSOM will not be responsible for other expenses incurred by the participant in the unlikely event that the program is canceled.

Equal Opportunity

  • StatPearls and CUSOM are Equal Opportunity / Affirmative Action / Equal Access Institutions. 

Medium or Media Used:

  • Computer Requirements:  Internet Access
  • E-mail Address

Instructions for Credit

  1. Register for the activity and create a StatPearls login.     
  2. Review the required accreditation information:  Target audience, learning objectives and disclosure information.
  3. Complete the entire self-study activity.
  4. Complete the post-test assessments.
  5. Successfully pass the post-test with a minimum score of 100%.
  6. Complete the evaluation form.
  7. Obtain a certificate.

StatPearls and CUSOM adheres to AOA Standards regarding commercial support of continuing medical education. It is the policy of StatPearls and Campbell that the faculty and planning committee disclose real or apparent conflicts of interest relating to the topics of this educational activity, that relevant conflict(s) of interest are resolved and also that authors and editors will disclose any unlabeled/unapproved use of drug(s) or device(s) during their presentation. Detailed disclosure will be made prior to starting the activity.

The information provided at this CME/CE 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.

This course is intended for osteopathic physicians who wish to earn AOA CME credit. Take this version of the course to ensure you receive appropriate credit.

 

 
 

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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