NUTCRACKER SYNDROME: A REPORT OF TWO CASES

Nutcracker syndrome is a pathology that could pose a diagnostic conundrum to the physician as the patient could present with vague symptoms. This report brings to limelight the pathology of Nutcracker syndrome and the need for clinicians to consider this as a differential diagnosis when managing patients with non-specific abdominal pain.

This is a case series report of two patients that presented at the emergency unit with acute exacerbation of insidious onset of upper abdominal pain. Radiological evaluation with computerized tomography proved the presence of this pathology in both patients with reduction in aortomesenteric angles and distances. The management of this clinical entity is largely conservative with surgical intervention rarely needed.

Radiological evaluation is the bedrock of diagnosis of Nutcracker syndrome. The clinician should endeavor to consider this as a differential diagnosis in patients with recurrent and undefined upper abdominal symptoms.