RETROAORTIC LEFT RENAL VEIN OR POSTERIOR NUTCRACKER SYNDROME: A RARE ANOMALY

Abstract

The term "Retroaortic Left Renal Vein" refers to a left renal vein that passes behind the abdominal aorta, and this anomaly is a rather unusual occurrence. It has been suggested that retroaortic left renal vein may cause symptoms such as haematuria and abdominal or ank pain. Urological symptoms are likely due to increased pressure in the left renal vein secondary to the posterior nutcracker phenomenon. We describe a highly uncommon case of a 35 year old woman who was admitted via the emergency department due to left sided ank pain for several days. A thorough examination with Contrast-enhanced CT revealed left renal vein compressed in between abdominal aorta and anterior margin of L1 lumbar vertebral body causing severe compression and mild proximal dilatation of left renal vein, with multiple venous collaterals majorly draining into the hemiazygos vein and the rest in inferior vena cava. The left gonadal vein appeared dilatated. These features were suggestive of posterior nutcracker syndrome