Case Report: A rare story of dysmenorrhea and hematuria in a young female with a case of nutcracker syndrome

Abstract

Nutcracker syndrome (NCS) is a sporadic syndrome due to the compression of the left renal vein (LRV) between the abdominal aorta and the superior mesenteric artery (SMA). This condition may present with unexplainable pain, hematuria, orthostatic hypotension, proteinuria, or dysfunction of the kidneys. These symptoms would be explained by the fact that if a chronically standing venous congestion is there then there could be the development of gonadal vein and pelvic vein collateral drainage pathways. Doppler USG (ultrasound), cross-sectional and invasive imaging modalities are frequently used for the purpose of diagnosis. Here, in this report, there's a female patient in her mid- 20's. She was asymptomatic since birth and presented with a history of abdominal pain and blood in the urine. USG is not the best modality for describing the findings hence a further contrast-enhanced computed tomography was done which reported an NCS. In all cases of unexplained hematuria, after excluding all differential diagnoses, NCS must be taken into account.