{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:14:49Z","timestamp":1791490489331,"version":"4.3.4"},"reference-count":64,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Das \u201eNussknacker\u201c-Syndrom ist ein sicher unterdiagnostiziertes Krankheitsbild, mit dem die Patienten h\u00e4ufig einen l\u00e4ngeren Leidensweg zur\u00fccklegen, ehe es ad\u00e4quat diagnostiziert und behandelt wird. Hinsichtlich der Behandlung existiert eine F\u00fclle unterschiedlicher therapeutischer Ma\u00dfnahmen, wobei die am ehesten kausal anmutende Ma\u00dfnahme, die Transposition der A. mesenterica superior, im Verh\u00e4ltnis wenig eingesetzt wird.<\/jats:p><jats:p>Basierend auf selektiven Referenzen der einschl\u00e4gigen medizinisch-wissenschaftlichen Literatur und eigenen klinisch-gef\u00e4\u00dfmedizinischen Erfahrungen sollen die wesentlichen Charakteristika des \u201eNussknacker\u201c-Syndroms dargestellt werden.<\/jats:p><jats:p>Es wurde ein narrativer Review unter Literatursuche in PubMed unter Nutzung der Stichworte \u201eNussknacker-Syndrom\u201c, \u201eMay-Turner-Syndrom\u201c, \u201eWilkie-Syndrom\u201c, \u201eaortomesenterialer Winkel\u201c, \u201epelvic congestion syndrome\u201c zum Thema verfasst.<\/jats:p><jats:p>Die Beschwerden des Nussknacker-Syndroms sind unspezifisch und mannigfaltig und sollten gerade in ihrer Kombination an ein Nussknacker-Syndrom denken lassen. Duplexsonografie und CT sind Methoden hoher diagnostischer Genauigkeit und k\u00f6nnen zudem relativ h\u00e4ufig simultan auftretende weitere Gef\u00e4\u00dfanomalien nachweisen. In Zusammenschau der Klinik und Paraklinik kann patientenspezifisch ein Therapieplan \u2013 a.\u00a0e. im Rahmen eines Stufenkonzeptes \u2013 festgelegt werden, in dem auch die Transposition der A. mesenterica superior ein kausales, effektives und sicheres Verfahren gerade bei kombinierten Gef\u00e4\u00dfanomalien wie May-Turner- oder Wilkie-Syndrom darstellt.<\/jats:p><jats:p>Das Nussknacker-Syndrom als ven\u00f6se Abflussbehinderung der Niere stellte, medizinisch gesehen, bislang selbst eine recht \u201eharte Nuss\u201c dar, wof\u00fcr die moderne Medizin durch Evidenzfindung nicht zuletzt durch Fallberichte und retrospektive Kohortenanalysen mittlerweile einen verifizierten diagnostischen und therapeutischen Algorithmus bereith\u00e4lt.<\/jats:p>","DOI":"10.1055\/a-2636-2267","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T23:25:48Z","timestamp":1752794748000},"page":"420-431","source":"Crossref","is-referenced-by-count":3,"title":["Transposition der A. mesenterica superior an der infrarenalen Aorta beim \u201eNussknacker\u201c-Syndrom"],"prefix":"10.1055","volume":"150","author":[{"given":"Stephan","family":"Arndt","sequence":"additional","affiliation":[{"name":"Arbeitsbereich Gef\u00e4\u00dfchirurgie; Klinik f\u00fcr Allgemein-, Viszeral-, Gef\u00e4\u00df- und Transplantationschirurgie, Otto-von-Guericke-Universit\u00e4t mit Universit\u00e4tsklinikum, Magdeburg, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Meyer","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein-, Viszeral-, Gef\u00e4\u00df- und Transplantationschirurgie, Otto-von-Guericke-Universit\u00e4t mit Universit\u00e4tsklinikum, Magdeburg, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udo","family":"Barth","sequence":"additional","affiliation":[{"name":"Arbeitsbereich Gef\u00e4\u00dfchirurgie; Klinik f\u00fcr Allgemein-, Viszeral-, Gef\u00e4\u00df- und Transplantationschirurgie, Otto-von-Guericke-Universit\u00e4t mit Universit\u00e4tsklinikum, Magdeburg, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maciej","family":"Pech","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Radiologie und Nuklearmedizin, Otto-von-Guericke-Universit\u00e4t mit Universit\u00e4tsklinikum, Magdeburg, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuhir","family":"Halloul","sequence":"additional","affiliation":[{"name":"Arbeitsbereich Gef\u00e4\u00dfchirurgie; Klinik f\u00fcr Allgemein-, Viszeral-, Gef\u00e4\u00df- und Transplantationschirurgie, Otto-von-Guericke-Universit\u00e4t mit Universit\u00e4tsklinikum, Magdeburg, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,7,17]]},"reference":[{"key":"ref1","first-page":"507","article-title":"\u201cNutcracker\u201d phenomenon of the renal vein and venous pathology of the left kidney","volume":"55","author":"A de Schepper","year":"1972","journal-title":"J Belge Radiol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/BF00518807","article-title":"\u00dcber den Verlauf und die H\u00e4ufigkeit der retroaort\u00e4ren linken Nierenvene bei menschlichen Feten","volume":"130","author":"J Hochgesand","year":"1970","journal-title":"Z Anat Entwickl Gesch"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1148\/radiographics.20.3.g00ma09639","article-title":"Spectrum of congenital anomalies of the inferior vena cava: cross-sectional imaging findings","volume":"20","author":"JE 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