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.
38 year old female with severe post thrombotic syndrome and severe venous ulceration for 8 years
46 year old male, type 1 diabetes, with ulcers on several toes. Patient had palpable pulses at the ankle.