精索静脈瘤破裂を来たしたナットクラッカー現象に対し自家腎移植を施行した1例

Abstract

A 31-year-old man visited our hospital complainingof swellingin the left scrotum. Five days previously, he had felt sudden pain in the left lower abdomen and noticed swellingin the left scrotum. He had been sufferingfrom intermittent gross hematuria and left flank pain for 1 year. An elastic hard mass was palpable in the left scrotum. Scrotal hematoma and marked dilation of left renal vein and left gonadal vein were revealed by computed tomography. A diagnosis of varicocele rupture secondary to nutcracker phenomenon was made. One month later, he underwent retroperitoneal laparoscopic donor nephrectomy and subsequent renal autotransplantation into the left iliac fossa. The post-operative course was uneventful. Gross hematuria was resolved 3 days after the operation, and swellingin the left scrotum was resolved within 6 months of the operation. Surgical intervention to treat nutcracker phenomenon is considered controversial. We believe that our procedure is a reliable option for surgical treatment for nutcracker phenomenon.