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Retrocaval ureter

Case contributed by Hani Makky Al Salam
Diagnosis certain

Presentation

Right renal pain.

Patient Data

Age: Adult
Gender: Male

Intravenous pyelogram

x-ray

Right hydronephrosis and dilated upper right ureter till the upper border of LV3 vertebral body, where it medially deviates.

Delayed opacification of the right ureter, reflecting obstruction.

Abdomen - non-contrast

ct

Non-contrast CT reveals mildly dilated upper segment of the right ureter which courses behind the IVC and exerts mild compression at this level.

Ureteric stone is noted at the middle segment of the right ureter below the level of IVC crossing, at the level of lower border of LV4 vertebral body with soft tissue rim sign representing the edematous ureteric wall.

Case Discussion

IVP and CT demonstrate partial obstruction of the right renal collecting system with a retrocaval ureter. Renal calculi are also present, presumably due to stasis. 

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