Anterior Nutcracker Syndrome: First Surgically Managed Case Reported in Benin.

Nutcracker syndrome is a rare condition caused by compression of the left renal vein, often underdiagnosed in adolescents. We report a 16-year-old male with painful left testicular swelling and grade 3 varicocele. Imaging confirmed anterior nutcracker syndrome. He underwent successful left renal vein transposition with complete symptom resolution and normal imaging at 24 months. Nutcracker syndrome should be considered in young patients with varicocele and testicular pain. Renal vein transposition is a safe and effective treatment when conservative approaches fail, with long-term clinical and radiological benefits.