What is nutcracker phenomenon, and what are its symptoms?

Generally, the "nutcracker phenomenon," also known as nutcracker syndrome, refers to the compression of the left renal vein as it drains into the inferior vena cava. This occurs when the left renal vein is trapped within the acute angle formed between the aorta and the superior mesenteric artery—resembling the shape of a nutcracker—leading to a series of symptoms including hematuria, flank pain, testicular pain, orthostatic proteinuria, and gonadal vein varicocele. Specific details are analyzed as follows:

1. Hematuria

The left renal vein is compressed by the left renal artery and the superior mesenteric artery, resulting in impaired venous return from the left kidney and causing hematuria. Patients are advised to take medications such as levofloxacin tablets or cefixime tablets as directed by their physician.

2. Flank Pain

Compression of the left renal venous system leads to dilation of the left renal vein. Congestion in the perivesical veins and genital veins that drain through this system can cause flank pain. It is recommended that patients use medications such as amoxicillin capsules or levofloxacin tablets under medical supervision.

3. Testicular Pain

Nutcracker syndrome is often caused by developmental abnormalities, which may lead to enlargement of the left testicle accompanied by localized pain. Patients are advised to take medications such as Yinhua Piyenling tablets or levofloxacin hydrochloride capsules as prescribed.

4. Orthostatic Proteinuria

This condition may be related to the upright posture, which increases levels of renin, angiotensin, and other substances in the bloodstream. Patients are recommended to use medications such as perindopril tert-butylamine tablets or captopril tablets as directed by their doctor.

5. Gonadal Vein Varicocele

This is a secondary condition caused by impaired venous return. Patients are advised to take medications such as ibuprofen tablets or L-carnitine injection according to medical advice.

In addition to the above, symptoms such as lower limb edema may also occur. Patients should maintain a balanced diet, ensure adequate sleep, engage in appropriate physical exercise, and seek timely medical attention for standardized treatment under professional guidance.