Nutcracker syndrome as an incidental finding on computed tomography scan after blunt abdominal trauma

Abstract

Background: The nutcracker syndrome refers to compression of the left renal vein between the aorta and the superior mesenteric artery. It may be asymptomatic for long period and constitute casual findings.

Aim: To report a new case diagnosed by radiological exploration after an abdominal trauma. The diagnosis and treatment of nutcracker syndrome are discussed.

Case: A 32-year-old man was a victim of traffic accident causing leg and abdominal trauma. Three days after orthopedic surgery, he presented an isolated gross hematuria. Abdominal computed tomography showed that the left renal vein was compressed between the aorta and the superior mesenteric artery. The diagnosis of nutcracker syndrome was established. Surveillance was indicated with excellent evolution.

Conclusion: The nutcracker syndrome is a rare entity. It may be asymptomatic. Its diagnosis is the privilege of medical imaging. Its treatment is controversial and should be discussed case by case.