Fig. 8

a–f trans-abdominal and spectral Doppler images showing anterior nutcracker of the left renal vein evidenced by (narrow aorto-mesenteric angle = 12.2 degrees and narrow aorto-mesenteric window =3.6 mm between the red lines) in (a, b) significant left renal vein dilatation (open white arrow) in (c) being entrapped as it passed in the aorto-mesenteric window (white asterisk) in (c) between the aorta (ao) and superior mesenteric artery (sma); this was proven by spectral Doppler interrogation that showed significant rise in the velocity ratio in the nutcrackered segment of the vein (d & e). The left gonadal vein dilatation (open white arrow) in (f) was secondary to left renal vein nutcracker (white asterisk) in (f) as it passed in the aorto-mesenteric window