Introduction
Nutcracker syndrome (NCS) is the symptomatic clinical condition in which of left renal vein (LRV) becomes compressed usually between abdominal aorta and superior mesenteric artery (SMA). NCS is important because secondary chronic LRV hypertension may lead to chronic renal disease or renal vein thrombosis (1). The most common cause of NCS is the short distance between SMA and abdominal aorta (1-4). Other reported causes are retroperitoneal pathologies as tumors or lymphadenopathies. Venous causes are very rare but splenic vein enlargement has not been reported. (1,3,5). NCS can happen at any age from childhood to seventh decade (6-11) with peaking spread in middle age adults (10,11). In this case, NCS is secondary to compression effect of enlarged splenic vein on LRV.