Left gonadal vein transposition in the nutcracker syndrome

The cause of pelvic congestion symptoms is usually nutcracker syndrome. We present the clinical case of a 58-year-old female patient who consulted for lumbar and left flank pain, microhematuria, and dyspareunia of 10 years of evolution. Angiotomography showed compression of the left renal vein at the level of the aortomesenteric compass, associated with pelvic varices. It was resolved with surgical treatment by transposition of the left gonadal vein to the inferior vena cava and embolization of the distal bed with coils and foam. The patient had an uncomplicated postoperative period with complete resolution of symptoms.