Nutcracker Syndrome: A Rare Cause of Hematuria

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. Conservative management was successfully adopted, with no complications reported over three years of follow-up. This case highlights the importance of distinguishing anatomical findings from clinically significant syndromes and supports non-invasive management in mild presentations.