Case report: Anomalous systemic drainage of ileocolic veins (veins of Retzius) causing pelviureteric junction obstruction

Abstract

Pelviureteric junction (PUJ) obstruction can be due to an intrinsic neuromuscular abnormality or due to extrinsic compression. The most common extrinsic cause of PUJ obstruction is an aberrant lower pole renal artery.[1] PUJ obstruction due to lienorenal collaterals has also been reported.[2] However, to the best of our knowledge, PUJ obstruction due to the veins of Retzius has not been reported in the literature. The veins of Retzius are important as they can be injured during right hemicolectomy and because they may provide a pathway for the hematogenous spread of colon cancer. Based on our case report, we would like to stress the importance of recognizing the veins of Retzius as a potential cause of PUJ obstruction which, if unrecognized, could lead to significant vascular complications, including hemorrhage and compromise of the venous return of the colon.