An Incidental Finding of Posterior Nutcracker Syndrome: A Case Report.

Posterior nutcracker syndrome (PNCS) is a rare vascular disorder involving the compression of the retro-aortic left renal vein between the aorta and the vertebral column. It often presents with left flank pain, hematuria, and varicocele. We report the case of a 39-year-old male who presented with diffuse abdominal pain, acute urinary retention, and left flank pain. Radiologic evaluation revealed retro-aortic left renal vein compression with proximal dilatation, consistent with PNCS. The atypical presentation and non-specific clinical findings led to a conservative management approach. This case highlights the diagnostic challenges of asymptomatic PNCS and underscores the need for further research into its management.