Spontaneous spermatic vein thrombosis as a circumstance of discovery of the nutcracker syndrome: An exceptional entity

Spontaneous thrombosis of a varicocele is an extremely rare event. Preoperatively, it may be misdiagnosed due to non-specific presentation because of its clinically indistinguishable from many other inguinal conditions. Case Report: We report a case of left spermatic vein thrombosis extending to the nearby renal vein diagnosed by Doppler ultrasound, in a 28-year-old male. Blood congestion caused by the nutcracker syndrome, which was incidentally found by computed tomography angiography, may therefore have contributed to the pathogenesis of the thrombosis in our patient. After undergoing surgical treatment (complete resection of the spermatic vein thrombosis), our patient is asymptomatic, with complete resolution of his pathology.Watchful observation was our option for the nutcracker syndrome. Conclusion: The diagnosis of spontaneous thrombosis of varicocele is difficult and it may be misdiagnosed before ultrasound examination, and should be considered in patients without usual risk factors of thrombosis vein. Our purpose is to raise clinicians awareness for this condition so that they will be more likely to diagnose it. Our recommendation is: before classification of the left spermatic vein thrombosis as spontaneous in the absence of the usual risk factors for thrombosis, nutcracker syndrome should be sought especially among young males.