A rare cause of unexplained left flank pain: Nutcracker Syndrome

Abstract

Nutcracker syndrome refers to the compression of the left renal vein, usually between the aorta and the superior mesenteric artery. Flank pain is the most common complaint and hematuria can be seen among the laboratory findings. This syndrome, which is more common in women with low body mass index, can be difficult to diagnose.A 41-year-old female patient with persistent left flank pain was admitted to our family medicine outpatient clinic. Despite many polyclinic applications, there was no finding that could explain the pain in the patient, who did not have any features in her history. Computed tomography requested in our family medicine outpatient clinic revealed that the left renal vein was compressed between the aorta and the superior mesenteric artery, and the patient was diagnosed with nutcracker syndrome.Nutcracker syndrome is difficult to diagnose and is a diagnosis of exclusion to be considered in patients presenting with atypical left flank pain. A wide variety of methods are used in the treatment, from conservative treatment to the endovascular stent and surgical treatment, depending on the severity of the symptoms.