Síndrome de cascanueces

Abstract

Primary care physicians, given the position they occupy in the care chain, must face the daily challenge of seeing all kinds of diseases, including urological ones that are not exactly very prevalent. Two cases and a literature review are presented on the renal nutcracker syndrome, consisting of the compression of the left renal vein between the superior mesenteric artery and abdominal aorta. It is more common in the third/fourth decade of life, more often in women than in men, but can also be seen in newborns. Clinically, it presents with urological (abdominal pain in the left side, macro- and microscopic haematuria, dysuria, and varicocele) or gynaecological symptoms (dysmenorrhoea, dyspareunia, post-coital pain, lower abdominal pain, pelvic varices, vulvar, gluteal). Abdominal angiography-CT with contrast is very useful for its diagnosis. Treatment can be conservative, although in some cases surgery may be necessary.