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Abstract
Nutcracker phenomenon refers to compression of the left renal vein, most commonly
between the aorta and the superior mesenteric artery, with impaired blood outflow
often accompanied by distention of the distal portion of the vein. The nutcracker
syndrome (NCS) is the clinical equivalent of nutcracker phenomenon characterized by
a complex of symptoms with substantial variations. Depending on specific manifestations,
NCS may be encountered by different medical specialists. Although it may be associated
with substantial morbidity, the diagnosis of NCS is often difficult and is commonly
delayed. Diagnostic and treatment criteria are not well established, and the natural
history of NCS is not well understood. We performed an initial review of the literature
through MEDLINE, searching from 1950 to date and using the keywords nutcracker syndrome,
nutcracker phenomenon, and renal vein entrapment. We performed additional reviews
based on the literature citations of the identified articles. We attempted to elucidate
clinical relevance of these conditions and their prominent features and to summarize
professional experience.