Anterior Nutcracker syndrome as a rare cause of hematuria in an 8 year old boy: A case report

Abstract

Prashant S Patil, Gupta Abhaya, Kothari Paras L, Kekre Geeta, Vishesh K Dikshit, Shahaji Deshmukh, Apoorva Kulkarni

Nutcracker syndrome is caused by a compression of the left renal vein between the aorta and the superior mesenteric artery. It results in left renal venous hypertension, and the subsequent development of venous varicosities of the renal pelvis, ureter, and gonadal vein. We report a rare case in an 8-year-old boy who presented with a history of intermittent episodes of hematuria leading to anemia and left flank pain. Ultrasound examination of abdomen revealed bulky left kidney and features of subacute medical renal disease. Computed tomography of abdomen showed compressed left renal vein between aorta and superior mesenteric artery. Authors report the successful operative management of this rare syndrome in a pediatric patient.