Nutcracker occurs when the left renal vein is compressed between the abdominal aorta and the superior mesenteric artery. When symptomatic (left flank pain, hematuria) it is called nutracker syndrome. If asymptomatic is called nutcracker phenomena. In this example, the patient had complaints of pelvic congestion only.
101 year old female, admitted to the hospital with foot and toe pain. Patient had a cool pulseless foot.
67 year old male, type1 diabetic, with painful ulceration at the tip of the second toe. Patient did not toe amputation.
Recurrent lower extermity DVT should prompt an investigation for venous outflow obstruction. Too often these patients are under treated.