Nutcracker Syndrome: A Case Report of Renal Vein Compression between the Aorta and Vertebra

Nutcracker syndrome (NCS) is a rare vascular disorder characterized by compression of the left renal vein between the abdominal aorta and the superior mesenteric artery (SMA), leading to a spectrum of symptoms including hematuria, flank pain, and varicocele.We present a unique case of NCS in a 35-year-old female who presented with persistent left flank pain and hematuria.Further imaging revealed compression of the left renal vein between the abdominal aorta and the adjacent vertebral body, an exceedingly rare variant of NCS.The patient was managed conservatively with close follow-up, and his symptoms improved over time.This case highlights the importance of considering atypical anatomical variations in the diagnosis and management of NCS.