Title:

Chronic Pain Management Considerations for Nutcracker Syndrome

Introduction:

Nutcracker Syndrome is a rare condition where the left renal vein is primarily compressed between the aorta and superior mesenteric artery (SMA). Clinical manifestations vary, but commonly include hematuria, left sided flank pain and autonomic dysfunction. When conservative management fails for Nutcracker Syndrome, surgical options include renal or gonadal vein transposition, venous bypass, renal autotransplantation, and endovascular stenting. A nephrectomy is reserved for cases nonamenable to venous decompression.