Does the term “nutcracker syndrome” make you think of a holiday keepsake? This rare vascular disorder can cause pain and other symptoms but can be difficult to diagnose.
What Is Nutcracker Syndrome?
In nutcracker syndrome, your left renal vein gets compressed by two nearby arteries in your abdomen. Your left renal vein carries blood out of your left kidney and into your inferior vena cava, your body’s largest vein, so it can flow back up to your heart.
The condition is called “nutcracker syndrome” because of how the arteries look as they compress the vein, like a nutcracker crushing a nut.
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Nutcracker Syndrome Symptoms
When your left renal vein gets compressed, blood cannot flow through it properly. Blood can pool and flow backward into nearby veins, causing swelling and leading to symptoms that can include:
- Abdominal (flank) pain
- Blood in your urine
Symptoms of nutcracker syndrome that occur in women are:
- Pelvic congestion syndrome, or varicose veins in the lower abdomen that can cause pain.
- Heaviness in the pelvic or genital area.
- Pain with sexual intercourse.
- Painful menstrual periods.
In men, symptoms appear as varicoceles or enlarged veins in the scrotum.
Some people have no symptoms, while others may have severe symptoms that affect them every day.
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Am I At Risk for Nutcracker Syndrome?
While nutcracker syndrome can affect anyone, it is most common in women in their 30s and 40s who are tall and slim. It can sometimes appear after rapid weight loss, or after pregnancy.
Nutcracker Syndrome Diagnosis
Nutcracker syndrome can be difficult to diagnose because its symptoms are similar to many other urological and gynecological disorders.
Once other conditions have been ruled out, your vascular surgeon may recommend imaging tests, like an ultrasound, CT scan, or MRI to screen for nutcracker syndrome.
Nutcracker Syndrome Treatment Options
Nutcracker syndrome can be treated, and treatments depend on your age, anatomy, and symptoms. In some cases, nutcracker syndrome may not need treatment, especially for patients who are:
- 18 years old or younger, as the condition may resolve itself as the patient grows.
- Adults with mild symptoms.
Treatments for nutcracker syndrome can include:
- Regular urinalysis, to check for blood in your urine.
- Stenting, which uses a tube made of metal mesh to hold your vein open and allow for healthy blood flow.
- Surgery to relieve the pressure on your vein.
To learn more about nutcracker syndrome, contact the UPMC Division of Vascular Surgery at (412) 802-3333.
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About Heart and Vascular Institute
The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine. We strive to provide the most advanced, cutting-edge care for our patients, treating both common and complex conditions. We also offer services that seek to improve the health of our communities, including heart screenings, free clinics, and heart health education. Find an expert near you.