Minimally invasive treatment of nutcracker syndrome in a young girl.

Abstract

Nutcracker syndrome is a vascular anomaly consisting of external compression of the left renal vein by the superior mesenteric artery and the aorta artery. It may manifest with recurrent abdominal or pelvic pain, flank pain, macro- or microscopic hematuria, gonadal varices, or asymptomatic. We present a 10-year-old female patient with chronic progressive pain of more than two years of evolution in the left flank and radiating to the pelvic area. A diagnosis of nutcracker syndrome was made. The surgical resolutuion consisted in the transposition of the left ovarian vein to the left iliac vein. The patient remains asymptomatic at one year of follow-up. In selected patients, venous decongestion of the left renal vein to the inferior vena cava using the ovarian vein is a low-complexity therapeutic possibility with a low incidence of complications.