title: Modified medial nephropexy for treatment of the anterior nutcracker syndrome.
abstract: We report the case of a 15-year-old male, presenting with recurrent gross hematuria complicated by acute anemia. Cystoscopy showed little bleeding from the left ureteral orifice. Diagnosis of left renal vein compression at the aortomesenteric space was established through color Doppler ultrasonography and computed tomographic angiography. Therapeutic attitude was interventionist in our case, performing successful management with modified medial nephropexy, with a retroperitoneal approch. To the best of our knowledge, we report the second case of left medial nephropexy for treatment of the anterior nutcracker syndrome. The first case of modified medial nephropexy was done by lowering the left renal vein from its initial position in the aortomesenteric angle through a restrict retroperitoneal approach.
authors.affiliation: Department of Urology, Cardiovascular Surgery, Hospital of Sahloul, Sousse, Tunisia.
authors.forename: Wissem
authors.initials: W
authors.lastname: Hmida
authors.affiliation: Department of Urology, Cardiovascular Surgery, Hospital of Sahloul, Sousse, Tunisia.
authors.forename: Faouzi
authors.initials: F
authors.lastname: Mallat
authors.affiliation: Department of Urology, Cardiovascular Surgery, Hospital of Sahloul, Sousse, Tunisia.
authors.forename: Mouna Ben
authors.initials: MB
authors.lastname: Othmen
authors.affiliation: Department of Urology, Cardiovascular Surgery, Hospital of Sahloul, Sousse, Tunisia.
authors.forename: Faouzi
authors.initials: F
authors.lastname: Limayem
authors.affiliation: Department of Urology, Cardiovascular Surgery, Hospital of Sahloul, Sousse, Tunisia.
authors.forename: Faouzi
authors.initials: F
authors.lastname: Mosbah
keywords: Anterior nutcracker syndrome; medial nephropexy; retroperitoneal approach