23 F year old female presents with hematuria. CT scan through the middle of the kidneys shows a normal right kidney in the excretory phase. There is a delay in the excretory phase of the right kidney with evidence of nutcracker effect on the renal vein by the SMA (dark blue arrowhead upper and lower image) with significant upstream distension of the left renal vein (teal blue arrowhead upper and lower images) The left kidney remains in corticomedullary phase (black arrowhead in lower image). The tumor is ill defined in this image but in part is appreciated (green arrowhead lower image).
Ashley Davidoff MD TheCommonVein.net 24165cL