Nutcracker Syndrome Presenting as a Varicocele: A Case Report


Alison Callegari*

Nutcracker Syndrome (NCS), is an uncommon diagnosis in paediatrics. It is caused when the Left Renal Vein (LRV) is compressed between the abdominal aorta and the Superior Mesenteric Artery (SMA). We describe a case of Nutcracker Syndrome (NCS) in a 16-year-old male who presented with a history of intermittent macroscopic hematuria, suprapubic pain and a scrotal mass. His physical exam was remarkable for a right sided, non-tender cyst and a left varicocele. The patient underwent imaging studies, whose findings were consistent with Nutcracker syndrome. This is an unusual presentation of an underreported/ uncommon pediatric syndrome and highlights the need for investigation with appropriate imaging and for the inclusion of nutcracker syndrome in the differential diagnosis.

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