Very late diagnosed Retrocaval ureter: A case report of a very rare entity in Cameroon, sub-Sahara Africa

Fola, Olivier; Essomba, Armel Quentin; Epoupa, Frantz Guy Ngalle; Ako, Forban; Essomba, Arthur

doi:10.1016/j.ijscr.2022.106908

Cited by 4 publications

(7 citation statements)

References 49 publications

(85 reference statements)

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“…Type 1 includes an inherent abnormality in the growth of the retrocaval section of the ureter leading to a blockage syndrome that needs surgical removal; type 2 is caused by external pressure on the regular ureter in its retrocaval area, which can be treated with plasty instead of removal [ 1 ]. One of the primary causes of its delayed diagnosis, and in some cases even after death, is its secretive development [ 11 ]. Symptoms typically develop in the third or fourth decade of life as a result of ureteral compression, leading to ureteral kinking and hydronephrosis either from the inferior vena cava pressing against the psoas muscle or from a nonfunctional retrocaval ureteral segment [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Retrocaval Ureter With Ureteric Stones: A Case Report

Alwadai,

Alqarni,

Ayed

2024

Cureus

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The retrocaval ureter is an uncommon anomaly where the ureter passes behind the inferior vena cava. Open surgery had been the gold standard for treatment. We are presenting a case of the retrocaval ureter with ureteral calculi, which was effectively managed by open surgery. A 27-year-old male presented with a nine-month history of flank pain. He had no history of chronic illnesses. Physical examinations and laboratory findings were within normal. A computed tomography (CT) scan was done to confirm the diagnosis of retrocaval ureter with ureteral stones. The subcostal incision was made. Then, the proximal and lower ureter was transected at the point where it went retrocaval. The stones were extracted; then, watertight anastomosis was done. Ultrasound used for the follow-up of the patient for six months showed no hydronephrosis. Retrocaval ureteral may have no symptoms or be linked to nonspecific symptoms. The diagnosis of the retrocaval ureter is frequently delayed. Surgical management is utilized in the majority of cases.

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Section: Discussionmentioning

confidence: 99%

Retrocaval Ureter With Ureteric Stones: A Case Report

Alwadai,

Alqarni,

Ayed

2024

Cureus

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“…Part of the circumcaval ureter is compressed by the IVC on the psoas muscle, kinked or adynamic leading to various degrees of ureteral obstruction and hydronephrosis. [ 9 12 ] The patients present with nonspecific symptoms in the third or fourth decade of life such as flank pains, urinary tract infections, stones, and even with nonfunctioning kidneys when left unattended. [ 9 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 9 12 ] The patients present with nonspecific symptoms in the third or fourth decade of life such as flank pains, urinary tract infections, stones, and even with nonfunctioning kidneys when left unattended. [ 9 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 7 8 ] The incidence of this condition has been reported as 0.06%–0.17% globally with most cases found at autopsy with an incidence of 1–2 in 1000 cases with a higher male preponderance. [ 7 8 9 ]…”

Section: Introductionmentioning

confidence: 99%

“…Only a few cases of circumcaval ureter have been reported out of sub-Saharan Africa[ 9 10 ] and, hence, could pose a diagnostic dilemma for specialists who may not have had the privilege of managing such cases in the past.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic dilemma and surgical management of circumcaval ureter: A case report

Igbokwe,

Ojah,

Kamba

et al. 2023

J West Afr Coll Surg

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Circumcaval ureter (CVU) is an uncommon congenital anomaly, in which the proximal ureter makes a loop posterior to the inferior vena cava (IVC) usually resulting in ureteric obstruction with consequential hydronephrosis and a right nonfunctioning kidney. It is also called a retrocaval or postcaval ureter. CVU is rarely encountered and, hence, may pose a diagnostic dilemma for radiologists and urologists. Clinical presentation occurs in the 3rd and 4th decades of life, manifesting mainly with flank pain. We present our experience in the diagnosis and management of CVU in a Nigerian Centre. A 56-year-old man presented with a 2-year history of recurrent, colicky right flank pain. He had been seen in multiple tertiary hospitals with no definitive diagnosis or treatment. A computerised tomography urogram showed an abnormally dilated proximal ureter with the classical fish-hook appearance and medial displacement, posterior to the IVC. At surgery, via an open, flank, extraperitoneal approach a CVU was found with significant stenosis and prestenotic dilatation. An excision of the stenotic segment with ureteroureterostomy was performed over a 6F D-J stent, and he had a smooth postoperative period. A CVU is extremely rare, and hence, the diagnosis can be missed. If left unattended, CVUs can progress to hydronephrosis and, eventually, a nonfunctioning right kidney. A high index of suspicion and early surgical intervention are key to a successful outcome.

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Retrocaval Ureter: An Incidental Finding of a Rare Cause of Hydronephrosis in Adult

Muhammad,

Umar,

Mustapha

2024

Nigerian Journal of Basic and Clinical Sciences

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Rarely, hydronephrosis can be caused by the retrocaval ureter. Its rarity and vague appearance make a proper diagnosis difficult for surgeons and radiologists to make. For successful surgical care, it is crucial to distinguish different causes of urinary tract obstruction, particularly urolithiasis, which is more prevalent. In the current standard of care, intravenous urography (IVU) is quickly being replaced with computed tomography urography (CTU) when evaluating patients who have hydronephrosis due to suspected urolithiasis, particularly ureterolithiasis. A retrocaval ureter, being the rarest cause of hydronephrosis in adults, can be accurately diagnosed using CTU, which shows its typical appearance. We reported a case of a 41-year-old man who presented with left flank pain for which his surgeon suspected obstructive renal calculi. On investigations, however, we found a retreocaval ureter on the right side with resultant moderate hydroureteronephrosis. We therefore demonstrate the value of CTU in determining rare causes of hydronephrosis as it exemplifies this circumstance. Retrocaval ureter is a rare cause of hydronephrosis and may be one of the challenging cases for urologists that need careful investigations, especially when asymptomatic.

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Very late diagnosed Retrocaval ureter: A case report of a very rare entity in Cameroon, sub-Sahara Africa

Cited by 4 publications

References 49 publications

Retrocaval Ureter With Ureteric Stones: A Case Report

Retrocaval Ureter With Ureteric Stones: A Case Report

Diagnostic dilemma and surgical management of circumcaval ureter: A case report

Retrocaval Ureter: An Incidental Finding of a Rare Cause of Hydronephrosis in Adult

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