Nutcracker phenomenon

Case contributed by Masoud Farhadi
Diagnosis certain

Presentation

Right lower quadrant abdominal pain.

Patient Data

Age: 15 years
Gender: Male
ct

Abdominal CT scan with IV and oral contrast demonstrates marked compression of the left renal vein between the superior mesenteric artery (SMA) and aorta and reduced aortic-SMA angle (27°).

Dilation of the pre-stenotic part of the left renal vein is seen.

Case Discussion

The nutcracker phenomenon is when the left renal vein is compressed between the superior mesenteric artery and the aorta by a reduced aortic-SMA angle.

It can be a common incidental finding on routine CT imaging and many patients can be asymptomatic1.

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