Inoue Yuta, Naitoh Yasuyuki, Ajiki Jun, Fukui Ayako, Yamada Takeshi, Fujihara Atsuko, Yamada Kaori, Hongo Fumiya, Ukimura Osamu
Department of Urology Kyoto Prefectural University of Medicine Kyoto Japan.
Department of Diagnostic Radiology Kyoto First Red Cross Hospital Kyoto Japan.
IJU Case Rep. 2021 Jun 3;4(5):273-276. doi: 10.1002/iju5.12304. eCollection 2021 Sep.
Ureteropelvic junction obstruction is a common congenital anomaly that causes hydronephrosis but rarely accompanies ipsilateral retrocaval ureter.
A 39-year-old woman, who visited to our hospital complaining of worsened right low back pain and fever, was diagnosed with right hydronephrosis due to ureteropelvic junction obstruction by contrast-enhanced computed tomography. Intraoperatively before the planned robot-assisted laparoscopic pyeloplasty, retrograde pyelography was performed to reveal concomitant ipsilateral retrocaval ureter. Laparoscopically, ureteropelvic junction obstruction due to aberrant blood vessel and coexisting retrocaval ureter was confirmed. Transposition of the ureter from posterior to anterior of the inferior vena cava and following dismembered pyeloplasty was performed. Two years after surgery, her right hydronephrosis improved and she had no complain of any symptom.
Retrocaval ureter is a rare abnormality; however, combination of preoperative retrograde pyelography and laparoscopic evaluation was important for management of this concomitant abnormality.
肾盂输尿管连接处梗阻是一种常见的先天性异常，可导致肾积水，但很少伴有同侧腔静脉后输尿管。
一名39岁女性因右下腹疼痛加重和发热前来我院就诊，经增强计算机断层扫描诊断为肾盂输尿管连接处梗阻导致的右肾积水。在计划进行的机器人辅助腹腔镜肾盂成形术之前，术中进行了逆行肾盂造影，发现同侧伴有腔静脉后输尿管。腹腔镜检查证实存在异常血管导致的肾盂输尿管连接处梗阻以及并存的腔静脉后输尿管。将输尿管从下腔静脉后方移位至前方，随后进行了离断性肾盂成形术。术后两年，她的右肾积水有所改善，且无任何症状主诉。
腔静脉后输尿管是一种罕见的异常情况；然而，术前逆行肾盂造影和腹腔镜评估相结合对于处理这种并存的异常情况很重要。
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