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Doppler ultrasound is the first-line imaging and allows the detection of all the typical signs of posterior nutcracker left renal vein stenosis, flow congestion and renal failure. Nutcracker syndrome should be suspected in older patients with left varicocele associated with hematuria. Failure to diagnose and treat these patients couldhave serious consequences for their health. Doppler ultrasound is the first-line imaging and allows the detection of all the typical signs of posterior nutcracker left renal vein stenosis, flow con

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