Nutcracker syndrome: A rare and potentially under diagnosed cause of haematuria.

Satyendra Persaud

Abstract

The nutcracker phenomenon results from the partial occlusion of the distal segment of the left renal vein (LRV) as a result of compression of the LRV between the Abdominal Aorta (AA) and the Superior Mesenteric Artery (SMA). Despite modern imaging modalities, the diagnosis of nutcracker syndrome is difficult and requires a high index of suspicion. We describe the case of a 20-year-old female with haematuria, abdominal pain and weight loss. Her diagnosis was delayed but was eventually made on CT angiography after several months and after numerous consultations with several different specialties. Endovascular stenting was followed by complete resolution of symptoms.