Posterior nutcracker syndrome combined with right renal artery aneurysm: a case report

Abstract

Background: Posterior Nutcracker syndrome (PNS) is a rare condition caused by the left renal vein was compressed between the abdominal aorta and the vertebral column. Diagnosis and therapeutic options of posterior nutcracker syndrome are still controversial, as symptoms are variable and not specific. Renal artery aneurysm (RAA) is also a rare disease and is generally discovered during diagnostic procedures performed with other conditions. Therefore, a patient co-ordinating both of these rare conditions cause enormous challenges in diagnosis and treatment.
 Method: A rare case report. 
 Clinical case: A 25 years old female had been hospitalized for macroscopic hematuria and pain in the hypogastrium. Renal duplex ultrasound and CT scan revealed retro aortic LRV and right renal artery aneurysm. She was operated successfully with anterior transposition of the LRV into the IVC, aneurysmectomy associated with revascularization of RAA.
 Conclusion: PNS combination with RAA is a rare condition unreported in medical literature, with treatment criteria still uncertain. However, surgery with anterior transposition of LRV and aneurysm repair may be a safe and effective technique.