Posterior Nutcracker Syndrome: A Pediatric Case Report and Literature Review

The nutcracker syndrome results from the compression of the left renal vein between the aorta and the superior mesenteric artery, leading to variable and nonspecific symptoms of venous congestion. The most common presentation of this syndrome is the classical or anterior form; however, atypical variants exist, including the posterior nutcracker syndrome, which occurs due to the compression of the left renal vein between the aorta and the lumbar spine. This paper describes the case of a 5-year-old patient with persistent gross hematuria and mild proteinuria, in whom glomerular involvement was ruled out. Given the atypical clinical presentation, an abdominal magnetic resonance angiography was performed, confirming the diagnosis of posterior nutcracker syndrome.