# Nutcracker syndrome: a case-based review

## TL;DR

Nutcracker syndrome is a condition caused by compression of the left renal vein, leading to symptoms like blood in urine and pain, and can be treated with stenting.

## Contribution

This paper presents a case-based review and highlights endovascular stenting as a modern treatment option for nutcracker syndrome.

## Key findings

- Nutcracker syndrome is characterized by symptoms such as haematuria and flank pain due to left renal vein compression.
- Endovascular stenting is an effective modern management option for treating nutcracker syndrome.
- Clinical diagnosis and management require awareness of the syndrome's varied presentations and imaging findings.

## 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.