title: [Nutcraker syndrome as a cause of recurrent hematuria in a young woman: a case report].
abstract: BACKGROUND
  The nutcracker syndrome is defined by the compression of the left renal vein between the aorta and superior mesenteric arteries, accompanied by a classic, but less specific, symptomatology.
  
  
  METHODS
  We reported a case of a 37-year-old woman who had been investigated because of intermittent gross hematuria of unknown origin. Computed tomographic angiography revealed compression of the left renal vein as it ran between the superior mesenteric artery and the abdominal aorta, associated with significant dilation of the left ovarian vein.
  
  
  CONCLUSIONS
  The nutcracker syndrome, caused by compression of the left renal vein by the aorta and superior mesenteric arteries, is probably more prevalent in women, and it is caused by specific situations, such as renal ptosis and paucity of retroperitoneal fat. Hematuria, a typical symptom, is due to rupture of the thin-walled septum separating the veins of the urinary collecting system. Imaging tests may help with the diagnosis. The best treatment is still elusive, but there are several surgical approaches, such as intravascular stenting, and also a conservative management. Diagnosis is usually delayed, and the syndrome should be included in the differential of hematuria of unknown origin.
authors.affiliation: Universidade Federal do Paraná, Rua General Carneiro 181, Curitiba, PR, Brazil. gustavolencimarques@ yahoo.com.br
authors.forename: Gustavo Lenci
authors.initials: GL
authors.lastname: Marques
authors.forename: José Gastão Rocha de
authors.initials: JG
authors.lastname: Carvalho
authors.forename: Marcelo Mazza do
authors.initials: MM
authors.lastname: Nascimento
authors.forename: Sérgio Godoy
authors.initials: SG
authors.lastname: Marks
authors.forename: Luís Guilherme
authors.initials: LG
authors.lastname: Olbertz
mesh_terms: D000328:Adult; D005260:Female; D006417:Hematuria / Q000209:etiology*; D006801:Humans; D012008:Recurrence; D059228:Renal Nutcracker Syndrome / Q000150:complications*