The Nutcracker Syndrome: Rare Cause of Pediatric Abdominal Pain

Abstract

Nutcracker syndrome results from compression of the left renal vein (LRV), usually in the fork formed by the abdominal aorta and the superior mesenteric artery (SMA), leading to stenosis of the aorto-mesenteric part of the left renal vein and dilation of its distal part. We report the case of a 10-year-old child, with no family history of renal disease, diabetes or hematuria. He was admitted to our clinic for paroxysmal abdominal pain in the epigastric area that was not improved by the usual analgesics, associated with vomiting without transit disorders or hematuria, and had been evolving for 10 days prior to his admission. The clinical examination was normal, the normal biological check-up, the abdominal CT scan was in favor of the Nutcracker syndrome. The treatment was symptomatic with a good evolution. Nutcracker syndrome is a rare entity, to be evoked in the diagnostic range of rare etiologies of unexplained abdominal pain.