Left Varicocele Revealing a Nutcracker Syndrome: A Case Report and Review of Literature

Abstract

Nutcracker syndrome (NCS) is a rare entity defined by the symptomatic hypertension of the left renal vein (LRV) compressed in the majority of cases between the superior mesenteric artery and the aorta. Hematuria, pelvic or back pain and left varicocele are the most commonly symptoms. Doppler ultrasound, computed tomography (CT) and selective left renal vein phlebography are useful to confirm the diagnosis. Treatment criteria are not well established, however for asymptomatic patients with no haematuria, the treatment remains conservative. We report the case of a 17-year-old man, with an intermittent left flank pain for 4 years and increasing volume of the left testicle for 8 months.