From feeling fine to doubled over in pain - the sudden onset of Nutcracker Syndrome

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Monday, October 30, 2023
From feeling fine to doubled over in pain - the sudden onset of Nutcracker Syndrome
A Philadelphia woman shares her battle with Nutcracker Syndrome and how she found help at Temple Health.

PHILADELPHIA (WPVI) -- When a major highway gets blocked, it usually means headaches on surrounding roads, too.

It's the same for our circulatory system when a vessel gets blocked.

For a young Philadelphia woman, the culprit was Nutcracker Syndrome.

"I was out for a walk one day, and there was a very sharp and intense pain that caused me to double over," recalls Sara Schoenleber.

But Schoenleber's primary care doctor couldn't find the cause. And the first scans and tests didn't show much.

Before long, daily life was too painful.

"I was unable to sit up in a chair. And I was unable to stand in one place for more than 15-20 seconds at a time," Schoenleber says.

After several emergency room visits, a keen-eyed radiologist finally spotted Nutcracker syndrome.

That occurs when the vein coming from the left kidney is squeezed between two arteries.

Dr. Kenneth Chavin, chief of abdominal transplant surgery at Temple Health, likens it to a beaver dam blocking a river.

"What happens is that blood that needs to get out of the kidney, because it still has the blood coming in through the renal artery, will cause pressure within the kidney," notes Dr. Chavin.

There's also pressure in other blood vessels, causing general abdominal or back pain, bloating, leg swelling, headaches, or blood in the urine.

Dr. Chavin sees patients from across the country, Canada, and England, hunting for long-lasting relief.

"One of my recent patients had been suffering with it for 30 years," he says.

And many have already had other procedures.

"Either surgery to reposition the vessel, they've had a wrapping of it with Gore-Tex to try to prevent the compression, to they've had stents placed to try to balloon open the narrowing," he says.

Dr. Chavin, a transplant surgeon, offers three other options: Remove the kidney if it's diseased, move it in the abdomen, or donate it.

After checking out many techniques, Schoenleber decided on donation.

"The path that would help someone else in addition to myself," she says. "The pain was gone from the minute I woke up from surgery."

And Schoenleber is now working on regaining her strength.

She considers herself very lucky to have solved her excruciating pain in just five months,

Dr. Chavin says everyone has those blood vessel crossovers, but very few ever develop the squeezing or symptoms.