Nutcracker syndrome (NCS) is known as a status of compression of the
left renal vein (LRV) between the abdominal aorta and superior
mesenteric artery (SMA). We here report a case of NCS in Marfan patients
with type B aortic dissection who presented with sudden gross hematuria.
Computed tomography revealed the compression of the LRV sandwiched
between the SMA and the dilated dissecting abdominal aorta. The
compression was released after surgical intervention and the hematuria
was promptly recovered. This report highlights that NCS should be
considered as a differential diagnosis of unexplained hematuria in
patients with the chronic dissecting aorta.