Retrocaval ureter, also termed circumcaval ureter or preureteral vena cava, is an anomaly of embryologic development of the ivc in which the ventral. We present a case of a 29yearold man with right renal colic symptoms that turned out to be a retrocaval ureter. The ureter is medial to the pedicle of the vertebral body blue arrow. To investigate the association of retrocaval ureter with other congenital abnormalities. Although this embryologic anomaly is commonly known to urologists as circumcaval or retrocaval ureter terms that are anatomically descriptive but misleading in regards to development it is not the result of an abnormality in ureteral development but rather an anomaly in the development of the inferior vena cava. Spiral computed tomography scan and magnetic resonance imaging have been recently considered the tool of choice for the diagnosis of inferior vena caval abnormalities. There was no evidence of urinary tract infection, and his renal function was normal. Retrocaval ureter is a rare anomaly due to an abnormal development. Its symptom is nonspecific, and urography is the key. A preureteric vena cava, also known as a retrocaval ureter, is a rare congenital malformation of the right human ureter, in which the ureter passes behind the inferior vena cava, causing compression possibly leading to hydronephrosis.
Large object storage in a database or a filesystem. Gladstones case, that of an acardiac monster, is the only example on record to date. Unfortunately both term suggest that ureter is at fault whereas in reality it is the ivc. Symptoms are due to ureteric obstruction, either extrinsic by the abnormal inferior vena cava. A retrocaval ureter is a rare anomaly in children and needs a high index of suspicion to be detected early in life. Learningradiology retrocaval ureter, circumcaval ureter. The prevalence of this condition is approximately 1 per 1,000 persons, with males 23 times more likely than females to develop the condition.
If the patient requires ureterolysis for a retrocaval ureter, the code 753. The ureter, instead of passing lateral to the vena cava, passes behind it, partially encircles it for a short distance, and then pursues its normal course ventral to the vena cava, downward into the bony pelvis and thence to the bladder. This paper deals with an interesting anomaly of the inferior vena cava which has been variously called postcaval ureter, retrocaval ureter, circumcaval ureter, and preureteric vena cava. Pdf laparoscopic ureterolysis and reconstruction of a. Retrocaval ureter kaohsiung j med sci march 2003 vol 19 no 3 129 discussion the first recorded case of retrocaval ureter was seen on autopsy and was described by hochstetter in 1893 1. A circumcaval ureter is a rare congenital anomaly usually associated with upper urinary tract stasis and an s or. Steganographic file systems are designed to give a high degree of protection. Persistence of both ventral and dorsal limbs will result in the ureter passing between the cavae. Retrocaval ureter is still a rare congenital anomaly. Ureteric stone is noted at the middle segment of the right ureter below the level of ivc crossing, at the level of lower border of lv4 vertebral body with soft tissue rim sign representing the edematous ureteric wall. Ureteral anomalies msd manual professional edition. Historical unix file systems, including ext3, use linear bitmaps to track free space, which is. Circumcaval ureterretrocaval ureter bmj case reports.
In 1893, hochstetter first described retrocaval ureter. In the retroperitoneum, the ureter is situated just lateral to the tips of the transverse processes of the lumbar vertebrae. Mullen and engel state that 55 cases have been reported. Full blood count, urinalysis and blood urea and creatinine were normal.
A retrocaval ureter circumcaval ureter is a developmental anamoly of inferior vena cava ivc. Largescale file systems and mapreduce stanford infolab. The designation preureteric vena cava more accurately. On questioning he reported mild rightflank discomfort. Laparoscopic ureterolysis and reconstruction of a retrocaval ureter. The term retrocaval ureter is used interchangeably with circumcaval or postcaval ureter, which describes the anatomic relationship of the ureter to the embryologically abnormal inferior vena cava. A little over 200 cases have been reported worldwide since hochstetters zrst. A 45yearold man presented to our clinic for a routine examination. The variability in the position of the ureter to the adult skeleton. A circumcaval ureter is a rare congenital anomaly usually associated with upper urinary tract stasis and an s or fishhook deformity of the ureter, in which the ureter itself passes behind the inferior vena cava. Retrocaval ureter and associated abnormalities springerlink. We prefer the designation circumcaval ureter, since it best describes the anomaly and since one of us w. A retrocaval ureter, which is also called circumcaval ureter, is an abnorm development of vena cava and ureter. The ureter is slightly dilated proximal to this point and returns to a normal position distal to its retrocaval placement.
The top level is an abstract formal model of the file system interface as defined in. Retrocaval ureter, also called circumcaval ureter or preureteral vena cava, is a rare congenital anomaly in which the ureter passes posterior to the inferior vena cava ivc. Surgical anatomy of the ureter wiley online library. Laparoscopic surgery for retrocaval ureter performed at srmc pediatric urology workshop 1920 april 2014 by dr. Both of these terms are somewhat misleading, as this configuration is considered a developmental anomaly of the inferior vena cava ivc. A maximumintensityprojection image of f18 fluorodeoxyglucose positron emission tomographycomputed tomography showed an inverted jtype deformity fishhook with. Full text full text is available as a scanned copy of the original print version. Links to pubmed are also available for selected references. This technique was initially described and popularized by harril as a form of treatment in patients with symptomatic hydronephrosis. Retrocaval ureter medigoo health medical tests and.
Cryptographic file systems store files and associated metadata only in encrypted. It consists of a division of the dilated renal pelvis with transposition,resection of the retrocaval segment of the ureter and terminoterminal reanastomosis, with good long term results 12. The diagnosis was based on the findings of excretory urography ivu and contrastenhanced computed tomography ct. Laparoscopic transperitoneal repair of retrocaval ureter. Retrocaval ureter is an uncommon clinical entity that generally causes upper urinary tract obstruction on the right side as the right ureter courses posterior to the inferior vena cava. First described by hochstetter in 1893, retrocaval ureter also known as circumcaval ureter is a rare congenital anomaly and the incidence is greater in males than females with the ratio of 2.
Retrocaval circumcaval ureter associated with solitary. Ct scan below the level of the kidneys demonstrates a more medial retrocaval placement of the right ureter. Diagnosis of retrocaval ureter should increase the awareness of the responsible physician on the possibility of concomitant malformations where treatment could prevent future symptoms. A comparative study of laparoscopic and open surgical. Clinical presentation and outcome of cats with circumcaval. The axial ct below shows the inferior ureter white arrow coursing posterior to the inferior vena cava red arrow. The ureter classically course medially behind the inferior vena cava winding around it and then passes laterally in front of it to then course distally to the bladder. Traditionally, file systems were implemented as part of os kernels. Campbell 5 stated in his 1963 textbook that about 90 cases had been reported to date, and the diagnosis was made preoperatively in 28. Ivu showed a typical jshaped deformity in the dilated right proximal ureteric segment with moderate hydronephrosis and a filling defect in the renal pelvis. Retrocaval ureter is a relatively rare anomaly that usually manifests in the third or fourth decades. Circumcaval ureter also referred to as retrocaval ureter or preureteral vena cava is a rare congenital anomaly with the ureter deviates medially and passes behind the inferior vena. The retrocaval ureter is a rare congenital anomaly in which the right ureter courses posterior to the inferior vena cava and partially encircles it, having some degree of obstruction as a consequence.
A formal model of a virtual filesystem switch arxiv. Retrocaval ureter definition of retrocaval ureter by. Both of these terms are somewhat misleading, as this configuration is considered a developmental anomaly of the ivc. Coronal reformatted mips image from a ct urogram demonstrates medial displacement of the right ureter at the level of l3 white arrow. Retrocaval ureter a rare cause of hydronephrosis in children. Pdf horseshoe kidney with a retrocaval ureter donald. We report a case of concomitant transitional cell carcinoma tcc in a circumcaval ureter and invasive bladder cancer. Retrocaval ureter rcu is a rare congenital anomaly in which the ureter passes posterior to the inferior vena cava ivc. Circumcaval ureter, also known as retrocaval ureter, is a term used to describe an abnormal course of a ureter that encircles the inferior vena cava. A steganographic file system for linux the computer.
Collection of directories and files on nonvolatile storage device, typically a disk or a disk partition. Note, however, that these procedure codes cannot be reported if the ureterolysis is performed laparoscopically. Two new cases of retrocaval ureter are discussed and a detailed electronic search of the literature was mainly focused on the concomitant abnormalities. Though congenital,it commonly manifests in the third to fourth decade of life.
Ureteral anomalies should be suspected in children with an episode of pyelonephritis or recurrent urinary tract infections. Contrastenhanced ct and diuretic renography are the methods of choice to. The first of our patients had also a glandular hypospadias and a supernumerary lumbar vertebra, while the second one. The proximal ureter deviates medially passing behind the ivc and winding around it before crossing. It is a term used to describe an abnormal course of a ureter that encircles the ivc. Medial deviation of the ureter should lead to a suspicion of a retrocaval ureter. Due to the persistence of the right subcardinal vein in the lumbar area, the vena cava develops ventral of the right ureter zhang et al, 1990. How to safeguard the ureter and repair surgical injury. Retrocaval ureter is one of the rarest congenital anomalies, and can be explained as an abnormality in embryogenesis of the inferior vena cava in terms of abnormal persistence of the right subcardinal vein, a condition in which the ureter deviates medially and passes behind the inferior vena cava, winding about and crossing in front of it from. A steganographic file system for linux university of. Get a printable copy pdf file of the complete article 2. Retrocaval ureter is also known as circumcaval ureter. Retrocaval ureter is a rare congenital abnormality resulting in the ureter passing dorsal to and being obstructed by the inferior vena cava.
Circumcaval ureters, otherwise known as retrocaval ureters, are a rare embryological venous malformation resulting in dorsal displacement of the ureter to the caudal vena cava. Four types of retrocaval ureter have been observed in man. Retrocaval ureter is a rare congenital anomaly, with the ureter passing posterior to the inferior vena cava. In that case, the most appropriate code is 50949 unlisted laparoscopy procedure, ureter. Abdominal ultrasonography revealed a right hydronephrosis. Aim of this paper was to debate novel issues concerning the embryologic anomaly of the inferior vena cava which may lead to the ureter obstruction and hydronephrosis. A 14 year old male presented with a three months history of right flank pain that was of sudden onset and initially colicky but had become constant. Retrocaval ureter also referred to as circumcaval ureter or preureteral vena cava is a rare congenital anomaly with the ureters passing posterior to the inferior vena cava. Testing typically involves ultrasonography of the kidneys, ureters, and bladder before and after voiding, and then fluoroscopic voiding cystourethrography.
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