Retrocaval ureter with vesicoureteric reflux, a very rare entity

Abstract

Introduction: A circumcaval ureter is a rare congenital anomaly in which the ureter passes behind inferior vena cava. VUR is rarely found in association with retrocaval ureter. Diagnosis and management are difficult. To our knowledge, we report a second case of retrocaval ureter with ipsilateral VUR.

Observation: A 9-year-old child was admitted with complaints of right renal pain. After workup a diagnosis of retrocaval ureter with VUR was made. He underwent ureteroureterostomy with excision of retrocaval segment and is being managed conservatively for low grade VUR.

Conclusion: In a child presenting with retrocaval ureter we should look for associated VUR. The problem is similar to pelviureteric junction obstruction and ipsilateral reflux. The management is to deal with obstruction first, followed by extravesical ureteric reimplanation or subureteric teflon injection for reflux.

Keywords: Anomalies; Retrocaval; Inferior venacava; Vesicoureteric reflux; Right subcardinal vein; Ureteroureterostomy