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Nutcracker Syndrome

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Hematuria

Patient Data

Age: 55 years
Gender: Male

CT Urography

ct

The left renal vein is compressed at its distal segment between the aorta and the superior mesenteric artery with mild proximal dilatation.

Case Discussion

In absence of other causes, the presence of compression of the left renal vein (nutcracker syndrome) is considered the likely cause of hematuria. The most common clinical manifestation of nutcracker syndrome is intermittent macroscopic hematuria, repeated episodes of gross hematuria, and left flank pain. Renal vein thrombosis can be an important complication.

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