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Este relato descreve um caso de síndrome de nutcracker posterior, em que a abordagem de escolha foi a cirurgia aberta, transpondo distalmente a veia gonadal esquerda na veia cava inferior. No meio dessa divisão sai uma artéria, a sacral média (ramo perigoso, pois poderá sangrar muito). A veia cava inferior (vci) é a diretora do departamento das veias
As anastomoses se formam entre as duas veias supracardinais, remanescentes da extremidade distal das veias cardinais posteriores, que formam a veia ilíaca comum esquerda no seu segmento caudal. Depois das gonadais vem a mesentérica inferior e depois dela vem a divisão da aorta nas ilíacas em ilíacas comuns q posteriormente irá se dividir em externa e interna
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