Beyzanur Yekiner (19), a first year nursing student living in Istanbul, has been going around doctor to doctor with symptoms such as severe kidney and abdominal pain and blood in her urine since she was 5 years old. He was treated with drugs for years, he constantly struggled with urinary tract infections and kidney stones, but his disease could not be cured, even a full diagnosis could be made. The young girl, who had been visiting 6-7 hospitals for 13 years and seeing dozens of doctors, was finally diagnosed with the angiography performed last year. It turned out that he had a “nutcracker syndrome (nutcracker disease)”, which developed as a result of the compression of the left renal vein by the aorta and the intestinal artery arising from the left renal vein, which had tortured him for years. Surgery was required for his treatment. However, no surgeons approached the operation because it was a very risky operation. Yekiner He struggled for 1 year to find a surgeon who would perform the operation. Finally, he learned that it could be done in Koşuyolu Yüksek İhtisas Training and Research Hospital. Yekiner, who regained his health after the surgery performed by Cardiovascular Surgeon Associate Professor Sabit Sarıkaya and his team last month, also lost his unbearable pain for years. was saved at the same time.
“THE SYMPTOMS NEED TO BE VERY CAREFUL”
Assoc. Dr. Sarıkaya pointed out that Yekiner’s disease, which has not been able to get a diagnosis since he was 5 years old, has very rare symptoms, and said, “Since 1992, my surgeon, we operated on a patient with “nutcracker syndrome” for the first time. It is difficult. If symptoms such as side pain of unknown cause and blood in the urine in childhood do not go away despite treatment, this syndrome should also be considered and tests should be done accordingly,” he said. Assoc. Dr. Sarikaya said:
“Our patient came with complaints of left flank pain and hematuria, that is, blood and protein leakage in his urine. The disease is defined as nutcracker syndrome. It is known as “nutkıran” in Turkish. It occurs due to the compression of the vein of the left kidney between the largest vein of the body, which we call the aorta, and the intestinal vein that comes out of it. This leads to complaints of blood in the urine (hematuria), protein leakage, and severe side pain and abdominal pain at the same time. Since this disease is usually seen from childhood, we need to be very careful with children who have blood in their urine despite treatment, and as physicians, we need to keep the nutcracker syndrome in mind. In scientific studies, it has been observed that in 30 percent of children with unexplained hematuria in childhood, the left kidney vessels are compressed like a nutcracker. In the future, dysfunction begins in the kidneys, and the person can go as far as losing his kidney.
“THE MOST DEFINITE TREATMENT SURGICAL METHOD”
Stating that there are three ways to treat the disease, Assoc. Dr. Sarıkaya continued his words by emphasizing that the patient can be followed up with medication, but this is not a definitive solution:
“There is also a non-surgical stent treatment. However, in stent treatment, the patient’s problem is still not fully resolved, since there is a risk of stent breakage, obstruction, and displacement. For this reason, the most definite method is surgery, that is, the entrapment of the vein is pulled from the large vein to lower levels and saved from that narrow angle. Frankly, patients can be diagnosed very rarely, so I’ve been in this business since 1992, it was the first surgery I had done in this way. For this reason, we examined all scientific data and surgical techniques before performing this operation, and as a team, we were able to perform a successful operation by deciding on the most accurate method for the patient.”
“I DID NOT EVEN DIAGNOSIS FOR YEARS”
Beyzanur Yekiner, on the other hand, stated that she had been traveling from hospital to hospital since she was 5 years old and expressed her feelings as follows:
“For 14 years, no diagnosis has been made in any hospital. Last year we went to a hospital, an angio was taken and it turned out that my disease was nutcracker syndrome. I was told that I had to have an operation, but no doctor dared to do it, because it was risky. We finally learned that the team at Koşuyolu Heart Hospital can do this, and that’s why we came to our teacher Sabit Sarıkaya. My surgery was successful, it’s been a month, all my complaints are gone. Every time I went to the doctor, I went in with the hope that there would be a solution now. But no solution was found. They could not diagnose my disease. I was in constant pain, I could not walk long distances. I could even go to school restlessly because of my pain. I went through a very difficult process for 14 years”
(DHA)