Abstract
Entrapment of the left renal vein between the aorta and superior mesenteric artery can cause renal venous hypertension, resulting in renal vein and left gonadal vein varices. This condition, which is a rare cause of hematuria and left flank pain, has previously been described as the nutcracker syndrome. It is not known why compression of the vein occurs in only a few cases, although passage of the left renal vein between the aorta and superior mesenteric artery is a normal anatomical finding. The diagnosis is made according to pressure gradients of the left renal vein and inferior vena cava during investigation of left hematuria. Surgery is controversial but autotransplantation is safe and it should be considered a treatment alternative. We report a case of the nutcracker syndrome managed by autotransplantation.
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