Nutcracker syndrome includes all manifestations related to venous stasis induced by stricture of the left renal vein (LRV) in the fork formed by the abdominal aorta and the superior mesenteric artery (SMA), leading to stenosis of the aorto-mesenteric part of the left renal vein and dilation of its distal part. The symptomatology is dominated by lumbar, abdominal and pelvic pain and microscopic hematuria. This syndrome can be aggravated during the pregnancy from 16 SA, this is due to the increase in renal plasma flow. Its diagnosis is based essentially on modern imaging means (CT scan, Doppler ultrasound, phlebography) and its treatment is controversial. We report the case of a woman aged 37 years, admitted with acute abdominal-pelvic pain with vomiting complicated by severe hypotension in a pregnancy of 32 weeks of amenorrhea in whom imaging revealed an inaugural nutcracker syndrome discovered for the first time during this pregnancy.

Keywords : Nutcracker Syndrome, Left Renal Vein, Pelvic Varices, Superior Mesenteric Artery, Ascites, 3rd Trimester Pregnancy.