Nutcracker Syndrome-A Rare but Important Cause of Varicocele in Adolescent Boys

Nutcracker syndrome is a complex of clinical symptoms due to compression of the left renal vein between abdominal aorta and superior mesenteric artery. Hematuria and pelvic or back pain are the most common presenting symptoms with varicocele being an uncommon clinical finding in these patients especially in children. Doppler ultrasound, computed tomography and selective left renal vein phlebography are useful to confirm the diagnosis. Treatment can be conservative or surgical depending on the severity of symptoms. Here, we report a 13-year-old boy with left flank pain and varicocele on examination who on evaluation was found to have nutcracker syndrome as the etiology.