Nutcracker syndrome: a case-based review

Ann R Coll Surg Engl. 2024 May;106(5):396-400. doi: 10.1308/rcsann.2023.0090. Epub 2023 Dec 1.

Abstract

The nutcracker phenomenon, also known as left renal vein entrapment, occurs when there is extrinsic compression of the left renal vein, most often between the abdominal aorta and the superior mesenteric artery. Nutcracker syndrome refers to the constellation of clinical symptoms that may arise from the nutcracker phenomenon, typically inclusive of haematuria, flank/pelvic pain, orthostatic proteinuria and (in male patients) varicocele. We provide a short review of the nutcracker syndrome including various diagnostic and therapeutic modalities. We utilise our own experience with a patient as a case study and highlight the modern management option of endovascular stenting.

Keywords: Endovascular; Nutcracker syndrome; Review.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Endovascular Procedures / methods
  • Flank Pain / etiology
  • Hematuria / etiology
  • Humans
  • Male
  • Renal Nutcracker Syndrome* / complications
  • Renal Nutcracker Syndrome* / diagnosis
  • Renal Nutcracker Syndrome* / diagnostic imaging
  • Renal Nutcracker Syndrome* / surgery
  • Renal Veins / diagnostic imaging
  • Stents*