Abstract
Retrocaval ureter (RCU) is a rare congenital anomaly in which the ureter passes posterior to the inferior vena cava (IVC). A little over 200 cases have been reported worldwide since Hochstetter's first report in 1893. We present two cases of retrocaval ureter which were successfully managed at the Cape Coast Teaching Hospital in Ghana. Case 1. A 55-year-old woman presented with a history of dull right flank pain of 2 years duration. Physical examination and basic laboratory investigations performed on her were normal. Abdominal ultrasound showed right hydronephrosis and a retrograde right ureteropyelogram (RPG) showed right hydroureteronephrosis with an “S” shaped proximal ureter. A diagnosis of retrocaval ureter was made and confirmed at surgery. Case 2. A 25-year-old man presented with dull intermittent right flank pain of 1 year duration. Clinical examination and laboratory investigation were normal. Abdominal ultrasound showed right hydronephrosis and a CT urogram made a diagnosis of retrocaval ureter which was confirmed at surgery. Conclusion. Retrocaval ureter is a rare congenital anomaly that is now increasingly being reported. Surgical treatment of symptomatic cases successfully relieves symptoms.
Highlights
Retrocaval ureter (RCU) is a rare congenital anomaly in which the ureter passes posterior to the inferior vena cava (IVC) [1]
The infrarenal IVC originates from dorsally located supracardinal vein, but when it develops from ventrally located subcardinal vein, the ureter is trapped posteriorly leading to pre-ureteral vena cava [2]
We present two cases of retrocaval ureter which were successfully managed at the Cape Coast Teaching Hospital in Ghana. is is the second case report from Ghana
Summary
Retrocaval ureter (RCU) is a rare congenital anomaly in which the ureter passes posterior to the inferior vena cava (IVC) [1]. The infrarenal IVC originates from dorsally located supracardinal vein, but when it develops from ventrally located subcardinal vein, the ureter is trapped posteriorly leading to pre-ureteral vena cava [2]. Very few cases have been reported from Sub-Saharan Africa including four from Nigeria and two from Ghana [6, 7]. We present two cases of retrocaval ureter which were successfully managed at the Cape Coast Teaching Hospital in Ghana. A 55-year-old woman presented with a history of dull right ank pain of 2 years duration. She was otherwise well and clinical examination of the abdomen was normal. A diagnosis of retrocaval ureter was made and the ndings at operation were that of right retrocaval ureter, proximal dilated ureteral segment and a normal distal segment lying between the aorta and IVC. e redundant retrocaval segment was mobilized and excised, and end-to-end anastomosis was achieved over a JJ stent. e patient’s symptoms resolved at follow-up
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