Retrocaval ureter

Clinical History

A history of right loin pain.

Imaging Findings

The patient was referred to the radiology department for an IVU examination with a 6-year history of intermittent right loin pain which had worsened over the previous 3 months. There was no history of previous uretric colic or haematuria. The control film did not reveal any abnormality. Two films from the IVU series are shown.

Discussion

There is an abrupt medial deviation of the upper right ureter to the left of the left lumbar pedicle. This is consistent with a retrocaval or circumcaval ureter wherein the upper segment of the right ureter deviates behind the inferior vena cava and descends in a medial course to its insertion into the bladder. The inferior vena cava may produce a compressive effect on the ureter causing hydronephrosis, as illustrated in this case. No additional imaging is necessary to confirm this diagnosis.

Urographic fndings of a retrocaval ureter are as follows: abrupt medial deviation of the right ureter to the left of the right lumbar pedicle, fish hook shape and hydronephrosis.

Differential Diagnosis List

Final Diagnosis

Retrocaval ureter

URL:	https://www.eurorad.org/case/1950
DOI:	10.1594/EURORAD/CASE.1950
ISSN:	1563-4086