Atwine Oscar, Mucunguzi Denis, Ebine Johnson, Ainomugisha Racheal, Muhumuza Joshua, Mwesigwa Marvin Mutakooha
Department of Surgery, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Department of Surgery, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Int J Surg Case Rep. 2023 Oct;111:108899. doi: 10.1016/j.ijscr.2023.108899. Epub 2023 Oct 3.
Retrocaval ureter is a rare developmental abnormality of the inferior vane cava. Commonly presents in the 3rd and 4th decades of life hence a rare presentation in the pediatric population. This condition presents a surgical challenge both in terms of diagnosis and management due to costly investigations and few urology specialists in resource limited settings. We present a case of retrocaval ureter surgically managed in a resource limited setting with excellent outcome.
A 13-year-old female presented with 3 months history of progressive right sided abdominal pain and history of treatment for recurrent lower urinary tract infections. Intravenous pyelogram showed a ureter with a fish hook shape. At laparotomy, the ureter was identified, divided, relocated and ureteroureterostomy done anterior to the inferior vena cava. The patient recovered with no complications.
To the best of our knowledge, this is the first reported case of retrocaval ureter in a child surgically managed in Africa. It's a congenital anomaly of the inferior vena cava not ureter hence a misnomer. Amidst of being in a less resourced setting, an intravenous pyelogram may be all that is required to make a diagnosis.
腔静脉后输尿管是下腔静脉一种罕见的发育异常。通常在人生的第三和第四个十年出现，因此在儿科人群中较为罕见。由于在资源有限的环境中进行昂贵的检查且泌尿外科专家较少，这种情况在诊断和管理方面都带来了手术挑战。我们报告一例在资源有限的环境中通过手术治疗的腔静脉后输尿管病例，效果良好。
一名13岁女性，有3个月进行性右侧腹痛病史及复发性下尿路感染治疗史。静脉肾盂造影显示输尿管呈鱼钩状。在剖腹手术中，识别出输尿管，将其切断、重新定位，并在下腔静脉前方进行输尿管输尿管吻合术。患者康复，无并发症。
据我们所知，这是非洲首例报道的通过手术治疗的儿童腔静脉后输尿管病例。它是下腔静脉的先天性异常而非输尿管异常，因此这一名称并不准确。在资源较少的环境中，静脉肾盂造影可能是做出诊断所需的全部检查。
