Circumcaval ureter

Dr Henry Knipe and Radswiki et al.

A circumcaval ureter, or retrocaval ureter, is a developmental anomaly of the inferior vena cava (IVC). Unfortunately both terms suggest that the ureter is at fault, whereas in reality it is the IVC. They are of two types:

  1. high loop
  2. low loop

Many patients with this anomaly are asymptomatic. Depending on the degree of compression patients may develop partial right ureteral obstruction or recurrent urinary tract infections due to urinary stasis. 

This congenital abnormality occurs as a result of the right supracardinal system failing to develop normally. The right posterior cardinal vein persists, and therefore ends up passing in front of the ureter. 

With one reported exception, the anomaly always occurs on the right side, as this is the side of the normal IVC. 

The proximal ureter courses posterior to the IVC, then emerges to the right of the aorta, coming to lie anterior to the right iliac vessels. Any chosen imaging modality will usually show a right hydroureteronephrosis above the segment embracing the IVC.

If treatment is required, surgical relocation of the ureter anterior to the IVC can be performed. 

Abdominal and pelvic anatomy
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Article information

rID: 12815
System: Urogenital
Section: Anatomy
Synonyms or Alternate Spellings:
  • Retrocaval ureter
  • Circumcaval ureters
  • Retrocaval ureters

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Cases and figures

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    Figure 1: circumcaval ureter
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    Case 1: plain film
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    Case 1: CT
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    Case 2
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    Case 3: reverse J configuration
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