Unique Nutcracker Phenomenon Involving the Right Renal Artery and Portal Venous System
Figure 1
Multiplanar reconstruction of a nutcracker phenomenon. (a) Axial view: the left renal vein is compressed between the portal vein anteriorly and the right renal artery posteriorly. The left renal vein is patent after it traverses behind the superior mesenteric artery although minor compression occurs at this point. (b) Coronal view: the left renal vein ceases abruptly before the renocaval junction. (c) Sagittal view: the left renal vein is patent as it traverses behind the superior mesenteric artery. (d) Sagittal view: the left renal vein is compressed between the right renal artery and the portal vein. Adjacent retroperitoneal fat is present but not the offending structure. (e) Axial view: the left ovarian vein is dilated and enhancing, whilst the right ovarian vein is not appreciated. White arrowhead: portal vein; white arrow: superior mesenteric artery; black arrowhead: left renal vein; black arrow: right renal artery; white arrow with black border: left ovarian vein; black and white striped arrow: posterior bend of portal vein compressing left renal vein.
