The roles of the liver and pancreas in renal nutcracker syndrome

Abstract Introduction To assess the frequency and significance of presence of the liver and pancreas at the left renal vein (LRV) level in patients with suspected renal nutcracker syndrome (NCS). Materials and methods We included 101 patients with hematuria who underwent urography three-dimensional CT between April 2009 and November 2013. These patients were divided into NCS ( n  = 25) and non-NCS ( n  = 76) patients according to the following CT criteria: (1) the presence of beak sign and (2) hilar-aortomesenteric left renal vein diameter ratio >4. Patients were grouped according to the presence of the liver and pancreas at the LRV: group LP (both liver and pancreas), group L (only liver), group P (only pancreas), and group O (neither liver nor pancreas). The difference in the frequencies of groups was analyzed between NCS and non-NCS patients. Multivariate analysis was used to determine the independent factors between NCS and non-NCS patients. Results The frequencies of group LP, group L, group P, and group O in NCS vs. non-NCS were 88% vs. 5.3% ( p p  = 0.75), 4.0% vs. 11.8% ( p  = 0.45), 4.0% vs. 80.3% ( p p  = 0.022), and group LP was an independent factor for the presence of NCS (odds ratio, 43.8; 95% confidence interval, 3.8–500.3; p Conclusion The presence of the liver and pancreas at the level of the LRV was frequently found in NCS and was the independent factor for NCS.