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Year : 2018  |  Volume : 25  |  Issue : 2  |  Page : 127-131

Nutcracker syndrome presenting as recurrent hematuria

1 Department of Radiology, University of Benin, University of Benin Teaching Hospital, Benin, Edo, Nigeria
2 Department of Internal Medicine, Nephrology Unit, University of Benin Teaching Hospital, Benin, Edo, Nigeria

Correspondence Address:
Dr. Blessing Ose-Emenim Igbinedion
Department of Radiology, University of Benin Teaching Hospital, Benin, Edo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/wajr.wajr_45_17

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Nutcracker syndrome(NCS) occurs from compression of the left renal vein between the abdominal aorta and the superior mesenteric artery. It is rare and commonly presents with hematuria, flank pain, and dysuria. A 27-year-old male with sickle cell trait presented with a 9-month history of total hematuria complicated with anemia necessitating blood transfusion. He had no overt signs of urogenital infestation, renal impairment, or trauma. Genotype was AS. Intravenous urography was normal. On cystoscopy, the bleeding was seen to be coming through the left ureteral orifice. Renal angiography showed left renal venous stasis and contrast extravasation into the upper calyces. An impression of NCS was made. Other imaging modalities(computed tomography and ultrasound) supported NCS. NCS should be suspected in cases of recurrent hematuria.

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