Concurrent nutcracker syndrome and superior mesenteric artery syndrome requiring duodenojejunal bypass and left renal vein transposition

Abstract

Nutcracker syndrome (NCS) is the condition of extrinsic compression of the left renal vein (LRV) from the narrowing of the aorto-mesenteric angle. The third portion of the duodenum can also be compressed at this location causing superior mesenteric artery syndrome (SMAS). Both syndromes are reportedly rare and often improved after conservative management. This case report describes a 40-year-old female with symptomatic SMAS treated by duodenojejunostomy who subsequently underwent left renal vein transposition for NCS.