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Nutcracker Syndrome

What is Nutcracker Syndrome?

Nutcracker syndrome is a rare condition that occurs when arteries in your abdomen press on your left renal vein. This vein moves blood away from your left kidney and back toward the heart. When this vein is constricted, it increases blood pressure in the area and causes some blood to flow back up the vein. This can lead to swelling in nearby blood vessels, causing symptoms and potential health complications. 

Nutcracker syndrome is caused by the position of your blood vessels. Some people are born this way. In other cases, the position could change due to growth or weight loss. Sometimes there's no clear reason why Nutcracker syndrome occurs. 

There are no pre-existing conditions or lifestyle risk factors that lead to Nutcracker syndrome. It seems to be more common in women, people in their 20s and 30s, and people with a lower body mass index. However, it can affect anyone from children to adults in their 60s. Rapid weight loss may increase risk.

When to Seek a Specialist

Nutcracker syndrome is rare, and many people are asymptomatic, but once you start experiencing symptoms, you should seek treatment from a specialist. 

Common symptoms include: 

  • Abdominal pain on the left side
  • For women, pelvic pain, pain during sex or while urinating
  • For men, varicose veins in the scrotum
  • Blood in the urine
  • May-Thurner Syndrome (may be associated with)

When you have a complex condition like Nutcracker syndrome, it’s a good idea to seek a second opinion. You may also want to get a second opinion if you’re not comfortable with the care you’re receiving from your current provider.

Request an appointment online with a Temple Health specialist. 

Why Temple for Nutcracker Syndrome

Temple has a multidisciplinary team of surgeons and other specialists, making it a regional leader in diagnosing and treating Nutcracker syndrome. Temple offers a variety of treatments, including renal autotransplantation surgery, as well as other advanced treatment options. 

Symptoms

The symptoms of Nutcracker syndrome include:

  • Flank pain — Pain in your abdomen or left side is usually due to swelling in the veins. It can also be caused by blood clots forming and passing through tubes that lead to the bladder. 
  • Pelvic pain in women — Varicose veins in the lower abdomen can cause pain or a heavy feeling in the pelvic area or genitals.
  • Blood in the urine — High blood pressure in the left renal vein can rupture tiny blood vessels in the urinary tract, causing blood to appear in the urine.
  • In women, pain during sex — Swollen veins in the pelvic area can make sex painful for women. This can also make urination painful. 
  • Varicose veins on the scrotum for men — The buildup of pressure can cause swelling in other blood vessels nearby, leading to visible varicose veins on the left side of the scrotum. 

Treatment Options

Temple Health has a multidisciplinary team of specialists who are experienced in diagnosing Nutcracker syndrome and can recommend the approach that is right for you. 

Treatment options for Nutcracker syndrome include:

  • Renal vein transposition — This surgery repositions your left renal vein to move it out of the way of the blood vessels that are pressing on it.
  • Stent insertion — In this minimally invasive procedure, a stent is inserted into the left renal vein to hold it open where it is being constricted.
  • Renal autotransplantation surgery — A transplant surgeon will move the entire kidney to a different location in your abdomen, avoiding the blood vessels that are crowding it. This is the most invasive surgical option, but you can lower the risk of complications by seeking care from an experienced team that performs a high volume of these procedures.
  • Therapeutic Nephrectomy — Removal of a kidney to aid in the treatment of the Nutcracker syndrome.

Ready for An Appointment?

If you're experiencing signs or symptoms of Nutcracker syndromeschedule an appointment or call 800-TEMPLE-MED (800-836-7536) today.

Learn more about our doctors and care team who diagnose and treat Nutcracker syndrome.