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European J Pediatr Surg Rep. 2018 Jan;6(1):e104-e107. doi: 10.1055/s-0039-1678567. Epub 2019 Feb 22.

Laparoscopic Repair of a Left Retrocaval Ureter in a 16-Year-Old Girl.

European journal of pediatric surgery reports

Anna Kadar, Lorena Vatra, Anca Avram, Daniela Stoica, Marcel Oancea

Affiliations

  1. Department of Pediatric Surgery, Clinical Emergency Hospital for Children "Marie Curie," Bucharest, Romania.
  2. Department of Pediatric Radiology, Clinical Emergency Hospital for Children "Marie Curie," Bucharest, Romania.

PMID: 30805276 PMCID: PMC6386645 DOI: 10.1055/s-0039-1678567

Abstract

Left retrocaval ureter is an extremely rare congenital malformation which is associated with situs inversus, duplicated or translated inferior vena cava (IVC). We report a female adolescent who presented with a history of intermittent, colicky lumbar pain. Diagnostic workup revealed left retrocaval ureter and left ureterohydronephrosis. The girl underwent laparoscopy. The renal pelvis and ureter posterior to the vena cava were dissected, transected at the caudal point of the dilated ureteral segment, and uncrossed and repositioned lateral to the vena cava. Ureteroureterostomy was performed over a double-J ureteral stent after spatulation of the distal ureter. The postoperative course was uneventful and the ureteral stent removed after 5 weeks. During follow-up, the patient is symptom-free. Our case demonstrates that our laparoscopic approach is feasible in this rare anatomic anomaly.

Keywords: fish hook sign; laparoscopic ureteroureterostomy; left circumcaval ureter; left retrocaval ureter; situs inversus

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