We report a 5-year-old girl with idiopathic hypercalciuria who developed gross hematuria and left flank pain despite normalization of calciuria, a renal stone, and microscopic hematuria. She was found to have nutcracker syndrome by renal Doppler ultrasound, which revealed the significant differences of the peak blood flow velocities in the two portions of the left renal vein.

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http://dx.doi.org/10.1111/j.1442-2042.2006.01411.xDOI Listing

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Nutcracker syndrome (NCS) is an uncommon vascular condition caused by the compression of the left renal vein (LRN), which may result in venous hypertension and clinical symptoms, including hematuria, flank pain, and pelvic congestion. This report describes the case of a 30-year-old woman with recurrent painless macroscopic hematuria, ultimately diagnosed with NCS based on clinical and radiological findings. Computed tomography (CT) angiography revealed a reduced aortomesenteric angle and LRN compression without signs of severe venous hypertension or collateral circulation.

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