Nutcracker syndrome: First case report causing left renal parenchymal varicose veins

We report a unique case of Nutcracker Syndrome (NCS) in a 30-year-old woman with chronic abdominal and flank pain. Contrast-enhanced CT revealed significant narrowing of the left renal vein between the superior mesenteric artery and abdominal aorta. Uniquely, renal intraparenchymal varices were present-unreported in prior NCS cases. Diagnosis was supported by ultrasound and CT angiography. In the absence of severe hematuria, renal dysfunction, or intractable pain, the patient is managed conservatively. Although surgical and endovascular options are available for NCS, conservative treatment is applied in cases without major complications.