Posterior nutcracker syndrome with left renal vein duplication as a cause of gross hematuria and recurrent left varicocele in an eight-year-old boy

Introduction: the posterior nutcracker syndrome with duplication of the left renal vein is extremely rare, especially in childhood, and often misdiagnosed because it embraces an extended non-pathognomonic spectrum of symptoms which imply a difficult diagnosis. case report: An eight-year-old boy with a history of left varicocele treated by Palomo technique one year ago, presented with intermittent painless hematuria. systemic examination revealed high degree of left varicocele. An abdominal computed tomography scan revealed left renal vein duplication. the retroaortic branch was compressed between aorta and the vertebral column, suggesting posterior nutcracker syndrome with left renal vein duplication. transposition of the posterior branch of left renal vein or autotransplantation of the left kidney were decided, but refused by parents of the patient and only the varicocele was managed.the child is currently asymptomatic and proposed to clinical and analytical assessment. conclusion: Although posterior nutcracker syndrome with duplication of the left renal vein is a rare entity, it