Use of Tubularized Bovine Pericardium in Left Renal Vein Transposition for Nutcracker Syndrome

Nutcracker syndrome is an extrinsic compression of the left renal vein by superior mesenteric artery anteriorly and aorta posteriorly resulting in hallmark manifestations hematuria, proteinuria, flank/pelvic pain. This case illustrates a patient with history flank pain intermittent gross hematuria every 2 weeks. The denies any pelvic pain, gastrointestinal or lower extremity symptoms. Urinalysis had red blood cells (RBCs), but no infection was noted. Cystoscopy normal. CT urogram showed duodenal between narrow aortic-SMA angle. underwent transposition to distal inferior vena cava via transabdominal approach. Left transected at IVC, however length too short create tension-free anastomosis. A bovine pericardium sheet tubularized used as interposition graft. Patient recovered well symptom-free. well-described surgical technique treatment nutcracker syndrome. Use prosthetic has been described. demonstrated use alternate conduit for reconstruction.