This case illustrates the features of nutcracker syndrome, also known as renal vein entrapment syndrome, and an uncommon cause of secondary hypertension. 

It should not be confused with  with superior mesenteric artery syndrome (aka Wilkie syndrome) which although also a superior mesenteric artery compression disorder, the SMA compresses the third part of the duodenum.

Case courtesy of Bob Cook, MD. Western Memorial Regional Hospital Corner Brook, Newfoundland.