Diagnostics and treatment of the left renal vein nutcracker syndrome: a literature review

Eimantas Dumskis1

1Faculty of Medicine, Vilnius University


Left renal vein nutcracker syndrome is defined as the compression of this vein between the abdominal aorta and superior mesenteric artery when these two forms an edgy angle. Other anatomical variations may also occur. Most often clinical symptoms of the nutcracker syndrome begin with unilateral hematuria, pain, dilatation of gonadic veins and orthostatic proteinuria in young adults or later in life. The nutcracker syndrome is diagnosed when all the other causes of hematuria are rejected. When this diagnosis is suspected, primary evaluation of the patients should include throughout physical examination, most common symptoms, their course, the severity of disorders and possible complications. Retrograde venography is held as a gold standard when diagnosing the nutcracker syndrome, however, not always this method alone can clarify the case. Treatment of this syndrome mostly depends on the patients’ age and the severity of the symptoms.

Keywords: left renal vein, nutcracker syndrome, diagnosis, treatment.