{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T10:10:07Z","timestamp":1745748607951,"version":"3.40.4"},"reference-count":16,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,2,6]]},"abstract":"<jats:p>Nutcracker syndrome (NCS) is caused by compression of left renal vein (LRV), usually between the aorta and the superior mesenteric artery (SMA). This can lead to obstruction of flow into the inferior vena cava and secondary left renal venous hypertension. Despite potential serious consequences, diagnosing NCS is often challenging, circuitous and commonly delayed. We report an extremely unique case of NCS. A 34-year-old woman presented with left flank pain and discomfort. On investigation, it was found that high pressure in the LRV, due to compression by the SMA, had led to a large venous aneurysm that had caused pelviureteric junction obstruction and hydronephrosis. Management was with stenting of the LRV and coil embolisation of the venous aneurysm with excellent clinical outcome.<\/jats:p>","DOI":"10.1136\/bcr-2017-222880","type":"journal-article","created":{"date-parts":[[2018,2,16]],"date-time":"2018-02-16T15:35:39Z","timestamp":1518795339000},"page":"bcr-2017-222880","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Renal nutcracker syndrome in a young lady: unusual findings and endovascular management"],"prefix":"10.1136","volume":"2018","author":[{"given":"Manish","family":"Taneja","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin Soo Yeng","family":"Chua","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4612-7763","authenticated-orcid":false,"given":"Kanika","family":"Daga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,2,16]]},"reference":[{"key":"2025042702522538000_2018.feb16_1.bcr-2017-222880.1","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1016\/S0022-5347(17)54230-5","article-title":"Left renal vein to inferior vena cava pressure relationship in humans","volume":"127","author":"Beinart","year":"1982","journal-title":"J Urol"},{"key":"2025042702522538000_2018.feb16_1.bcr-2017-222880.2","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1148\/radiology.160.3.3737903","article-title":"Left renal vein hypertension in patients with left renal bleeding of unknown origin","volume":"160","author":"Nishimura","year":"1986","journal-title":"Radiology"},{"key":"2025042702522538000_2018.feb16_1.bcr-2017-222880.3","doi-asserted-by":"publisher","DOI":"10.4065\/mcp.2009.0586"},{"key":"2025042702522538000_2018.feb16_1.bcr-2017-222880.4","doi-asserted-by":"crossref","first-page":"41","DOI":"10.3389\/fneur.2014.00041","article-title":"Balloons and stents in the endovascular treatment of cerebral aneurysms: vascular anatomy remodeled","volume":"5","author":"Piotin","year":"2014","journal-title":"Front Neurol"},{"key":"2025042702522538000_2018.feb16_1.bcr-2017-222880.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2005.05.045"},{"key":"2025042702522538000_2018.feb16_1.bcr-2017-222880.6","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1007\/s00276-012-1027-7","article-title":"An unusual case of left venous renal entrapment syndrome: a new type of nutcracker phenomenon?","volume":"35","author":"Polguj","year":"2013","journal-title":"Surg Radiol Anat"},{"key":"2025042702522538000_2018.feb16_1.bcr-2017-222880.7","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1016\/j.ijscr.2013.10.012","article-title":"Posterior nutcracker syndrome with left renal vein duplication: An uncommon cause of hematuria","volume":"4","author":"Shah","year":"2013","journal-title":"Int J Surg Case Rep"},{"key":"2025042702522538000_2018.feb16_1.bcr-2017-222880.8","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.radcr.2017.10.007","article-title":"Left inferior vena cava with nutcracker syndrome: A case report","volume":"13","author":"Pulgarin Ricardo","year":"2018","journal-title":"Radiol Case Rep"},{"key":"2025042702522538000_2018.feb16_1.bcr-2017-222880.9","first-page":"71","article-title":"The nutcracker syndrome. Morphology and clinical aspects of the important vascular variations: a systematic study of 112 cases","volume":"35","author":"Orczyk","year":"2016","journal-title":"Int Angiol"},{"key":"2025042702522538000_2018.feb16_1.bcr-2017-222880.10","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1016\/S0022-5347(17)56121-2","article-title":"The \"nutcracker\" phenomenon: an unusual cause for renal varicosities with hematuria","volume":"123","author":"Wendel","year":"1980","journal-title":"J Urol"},{"key":"2025042702522538000_2018.feb16_1.bcr-2017-222880.11","doi-asserted-by":"publisher","DOI":"10.1016\/0090-4295(78)90365-5"},{"key":"2025042702522538000_2018.feb16_1.bcr-2017-222880.12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.1994.tb16575.x"},{"key":"2025042702522538000_2018.feb16_1.bcr-2017-222880.13","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/S0022-5347(17)37893-X","article-title":"The nutcracker syndrome: new aspects of pathophysiology, diagnosis and treatment","volume":"146","author":"Hohenfellner","year":"1991","journal-title":"J Urol"},{"key":"2025042702522538000_2018.feb16_1.bcr-2017-222880.14","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1097\/01.RVI.0000149904.26242.54","article-title":"Long-term follow-up after endovascular stent placement for treatment of nutcracker syndrome","volume":"16","author":"Kim","year":"2005","journal-title":"J Vasc Interv Radiol"},{"key":"2025042702522538000_2018.feb16_1.bcr-2017-222880.15","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.1097\/01.RVI.0000178259.87608.EC","article-title":"Endovascular stent placement for the treatment of nutcracker phenomenon in three pediatric patients","volume":"16","author":"Chen","year":"2005","journal-title":"J Vasc Interv Radiol"},{"key":"2025042702522538000_2018.feb16_1.bcr-2017-222880.16","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1002\/jcu.20811","article-title":"Nutcracker syndrome in a patient with a history of inferior vena cava ligation","volume":"39","author":"Peker","year":"2011","journal-title":"J Clin Ultrasound"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-222880","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T09:52:34Z","timestamp":1745747554000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-222880"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,16]]},"references-count":16,"alternative-id":["10.1136\/bcr-2017-222880"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-222880","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2018,2,16]]}}}