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Forum Name: Nephrology Symptoms

Question: Nutcracker phenomenon

 Lillyofparadise - Wed Jul 21, 2010 3:53 pm

I wonder what other possible complications could a person with the "nutcracker phenomenon" have?
 Dr.M.Aroon kamath - Thu Jul 22, 2010 2:00 pm

User avatar Hi,
"Nutcracker phenomenon" refers to compression of the left renal vein, in the angle between the aorta and the superior mesenteric artery, with drainge of the blood via the vein often accompanied by distention of the distal portion of the vein.

A distinction has been proposed to distinguish "nutcracker phenomenon", which is a radiologic finding in an asymptomatic individual, from "nutcracker syndrome" (NCS), which is characterized by the combination of radiologic findings of meso-aortic compression of the left renal vein and dilated collateral veins associated with clinical picture of chronic left flank pain, haematuria, orthostatic proteinuria, and pelvic venous congestion.

This syndrome can only be diagnosed after excluding all known causes of hematuria.

Some of the reported complications are,

- Postural Orthostatic Tachycardia Syndrome (pediatric chronic fatigue syndrome): a Common finding in some studies on pediatric NCS patients associated with orthostatic hypotension and chronic fatigue.

- left renal venous hypertension leading to pericaliceal varices causing unilateral severe hematuria, the originally reported symptom of NCS.

- development of varicosities of the gonadal veins.

- occasionally varicoceles among men and

- abnormal menstruation among women.

Hope this information is helpful. Best wishes!


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