Circumcaval ureter

Case contributed by Dr Abdulmajid Bawazeer

Presentation

Recurrent urinary tract infection.

Patient Data

Age: 25 years
Gender: Male
Ultrasound

The right kidney shows hydronephrosis with right proximal ureteric dilatation (appears to be adjacent to IVC) without a detectable renal stone.

Intravenous pyelogram

Fluoroscopy

The right kidney shows hydronephrosis and right proximal ureteric dilatation with medial deviation and an abrupt change in mid-ureter caliber without detectable radio-opaque shadows along the course of the urinary tract. 

CT urogram

CT

The right proximal ureter courses posterior to the IVC, then emerges from between the aorta and the IVC, coming to lie anterior to the right iliac vessels with normal excretion of contrast.

Case Discussion

Retrocaval ureter, also known as circumcaval ureter is a rare congenital anomaly in which the right ureter passes behind the inferior vena cava, and then emerges between the IVC and aorta and passes anterior to the IVC. One of the modes of presentation is recurrent urinary tract infections.

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