Nutcracker occurs when the left renal vein is compressed between the abdominal aorta and the superior mesenteric artery. When symptomatic (left flank pain, hematuria) it is called nutracker syndrome. If asymptomatic is called nutcracker phenomena. In this example, the patient had complaints of pelvic congestion only.
59 year old male with short distance exercise induced left leg pain. Pain was severe and was interfering with the patients actively living.
Nutcracker syndrome is one of the causes of secondary pelvic congestion syndrome.
Recurrent lower extermity DVT should prompt an investigation for venous outflow obstruction. Too often these patients are under treated.