Fola Olivier Kopong, Essomba Armel Quentin, Epoupa Frantz Guy Ngalle, Ako Forban, Essomba Arthur
Department of Surgery, Douala General Hospital, Teaching hospital, Douala, PO BOX 4856, +237, Cameroon; Department of Surgery and Subspecialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, PO BOX 1364, +237, Cameroon.
Department of Surgery, Douala General Hospital, Teaching hospital, Douala, PO BOX 4856, +237, Cameroon.
Int J Surg Case Rep. 2022 Mar;92:106908. doi: 10.1016/j.ijscr.2022.106908. Epub 2022 Mar 1.
Retrocaval ureter (RCU) is a rare congenital anomaly usually associated with upper urinary tract stasis, in which the ureter itself passes behind the inferior vena cava. RCU is often misdiagnosed and can lead to serious complications related to the upper urinary tract stasis.
We report the case of a 57-year-old female who presented with 1-year history of intermittent right flank pain, of gradual onset. She was diagnosed with right RCU, with advanced functional deterioration of the kidney, managed by nephrectomy. The postoperative course was uneventful.
RCU results in varying degrees of hydronephrosis and thus, in a non-specific clinical presentation. Most cases are asymptomatic, discovered only during imaging or surgery for unrelated conditions or at autopsy. A late diagnosis can lead to an obstructive nephropathy which can be very harmful to the kidney.
RCU is a very rare entity. The diagnosis can sometimes be late in under-medicalized settings, and must be taken into consideration in front of any hydronephrosis associated or not with intermittent flank pain. RCU-related complications can be very serious. Fish hook sign may be absent in case of nonfunctional kidney and must not exclude the diagnosis. Emphasis should be placed on prenatal diagnosis and routine abdominal ultrasound for early detection.
腔静脉后输尿管（RCU）是一种罕见的先天性异常，通常与上尿路梗阻有关，其输尿管走行于下腔静脉后方。RCU常被误诊，可导致与上尿路梗阻相关的严重并发症。
我们报告一例57岁女性，有1年逐渐起病的间歇性右侧腰痛病史。她被诊断为右侧RCU，伴有肾脏功能严重恶化，行肾切除术治疗。术后过程顺利。
RCU可导致不同程度的肾积水，临床表现无特异性。大多数病例无症状，仅在因无关疾病进行影像学检查或手术时或尸检时发现。延迟诊断可导致梗阻性肾病，对肾脏危害极大。
RCU是一种非常罕见的疾病。在医疗资源不足的地区，有时诊断会延迟，对于任何伴有或不伴有间歇性腰痛的肾积水病例都必须考虑到RCU。RCU相关并发症可能非常严重。无功能肾时可能无鱼钩征，但不能排除诊断。应重视产前诊断和常规腹部超声检查以早期发现。
