Friday, July 27, 2012

Nutcracker syndrome

The aorta, the body’s main artery originates from the heart; in the tummy region it gives off several other arteries that supply organs with blood. The inferior vena cava (IVC) returns blood from the lower body back to the heart. In the tummy, the aorta and IVC lie side by side; the aorta lies on the IVC’s left side.
One of the aorta’s tummy branches is the superior mesenteric artery (SMA) which supplies the intestines with blood.
Blood returning from the left kidney (within the left renal vein) must cross in front of the aorta to reach the IVC because of the relationship between the aorta and IVC - the aorta lies on the IVC’s left side.
Rarely, the left renal vein can become compressed between the SMA and aorta causing it to dilate. The SMA and aorta in this situation have been likened to the handles of a nutcracker squashing a nut which in this case is the left renal vein – nut cracker phenomenon (renal vein entrapment syndrome).
When the nutcracker phenomenon causes disease such as blood in the urine, tummy pain, the situation is then known as the nutcracker syndrome.
Navarro J, Azua-Romeo J, Tovar MT, Lopez JA. Nutcracker syndrome: a rare anatomic variant. BJUI, 2012 DOI: 10.1002/BJUIw-2011-092-web Go to reference
Go to Improbable version of this post

Anatomy, Nutcracker

Friday, July 20, 2012

Sunflower cataracts

The body needs the metal copper for some of its functions such as assisting enzymes carry out their task of facilitating biochemical reactions.
In the rare inherited disease – Wilson’s disease – named after a doctor who described it, copper accumulates abnormally mainly in the liver and brain. Because of excess copper, the lens of the eye can look like a sunflower – sunflower cataracts. A cararact is cloudiness of the eye’s lens which can result from numerous causes.
Treatment for Wilson’s disease includes avoiding foods with copper, using medications which prevent absorption of dietary copper or bind to copper within the body and liver transplantation.
Goyal V, Tripathi M. Sunflower cataract in Wilson's disease. J Neurol Neurosurg Psychiatry, 2000 69(1): 133. Go to reference

Sunflowers, eye 

Friday, July 6, 2012

Celery-stick sign

Abnormal alternating dense (sclerotic) and not so dense (lucent) bone at the ends (metaphysis) of the thigh bone (femur) and shin bone (tibia) can occur following infection of the developing baby (via an infected mother) with the rubella virus particularly during the first weeks of pregnancy.
These bands of alternating sclerotic and lucent bone are seen on radiographic - X-ray - images and they resemble celery sticks/stalks in look – celery-stick sign.
Vaccination of both females and males against the rubella virus helps prevent harmful effects of the rubella virus on the baby such as deafness, blindness, heart defects and other dreadful manifestations of the congenital rubella syndrome.
The celery-stick sign is not unique to congenital rubella.
Please also see salt and pepper retinopathy (click here).
de Mol AC, Vrancken S, Eggink AJ, Verduyn Lunel FM, Warris A. [The first newborn with congenital rubella syndrome during the rubella epidemic in The Netherlands in 2004/'05]. Ned Tijdschr Geneeskd, 2006 150(13):741-6.
Celery, rubella virus
3D animation of rubella virus - courtesy of Martin Gardiner