Case Presentation of Preureteral Vena Cava and Review  of the Literature

Hyseni, Nexhmi; Llullaku, Sadik; Berisha, Murat; Shefkiu, Ardian; Grajqevci, Salih; Jashari, Haki; koqinaj, Defrim; Hyseni, Fjolla; Bytyci, Islam; Muqolli, Fehim

doi:10.4236/oju.2013.35038

Cited by 11 publications

(6 citation statements)

References 8 publications

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“…Human patients with preureteral vena cava are generally asymptomatic . Depending on the degree of compression of the ureter by the preureteral vena cava, patients may develop partial right ureteral obstruction or recurrent urinary tract infections due to urinary stasis.…”

Section: Introductionmentioning

confidence: 99%

Multidetector‐row Computed Tomographic Characteristics of Presumed Preureteral Vena Cava in Cats

Pey

Marcon

Drigo

et al. 2015

Vet Radiology Ultrasound

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Preureteral vena cava (circumcaval ureter, retrocaval ureter) occurs in a third of the feline population and has been associated with ureteral strictures in humans. The aim of this retrospective cross-sectional study was to describe the contrast-enhanced multidetector row computed tomographic (MDCT) characteristics of presumed preureteral vena cava in a group of cats. Medical records from two institutions located in different continents were searched from 2010-2013 for cases with complete contrast-enhanced MDCT examinations of the abdomen (i.e. included the entire course of the ureters and prerenal and renal segments of the caudal vena cava) and a diagnosis of preureteral caudal vena cava. For cases meeting inclusion criteria, CT scan data were retrieved and characteristics of the preureteral caudal vena cava were recorded. Presence of concomitant renal or ureteral diseases was also recorded. A total of 272 cats had contrast-enhanced abdominal CT scans during the study period and of these, 68 cats (22.43 ± 4.96%) had a diagnosis of presumed preureteral vena cava. In all affected cats, a "reverse-J ureter" was observed, i.e. a ureter running medially at the level of L4-5, passing dorsally to the caudal vena cava and then exiting ventrally between the caudal vena cava and aorta returning to its normal position. Having a preureteral vena cava resulted in an increased risk for concurrent urinary signs (OR = 3.00; CI: 95%; 1.28-6.99; P = 0.01). Findings supported the use of contrast-enhanced MDCT for characterizing morphology of preureteral vena cava and its relation with ureters in cats.

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Section: Introductionmentioning

confidence: 99%

Multidetector‐row Computed Tomographic Characteristics of Presumed Preureteral Vena Cava in Cats

Pey

Marcon

Drigo

et al. 2015

Vet Radiology Ultrasound

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“…Part of the circumcaval ureter is compressed by the IVC on the psoas muscle, kinked or adynamic leading to various degrees of ureteral obstruction and hydronephrosis. [ 9 12 ] The patients present with nonspecific symptoms in the third or fourth decade of life such as flank pains, urinary tract infections, stones, and even with nonfunctioning kidneys when left unattended. [ 9 ]…”

Section: Discussionmentioning

confidence: 99%

Diagnostic dilemma and surgical management of circumcaval ureter: A case report

Igbokwe,

Ojah,

Kamba

et al. 2023

J West Afr Coll Surg

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Circumcaval ureter (CVU) is an uncommon congenital anomaly, in which the proximal ureter makes a loop posterior to the inferior vena cava (IVC) usually resulting in ureteric obstruction with consequential hydronephrosis and a right nonfunctioning kidney. It is also called a retrocaval or postcaval ureter. CVU is rarely encountered and, hence, may pose a diagnostic dilemma for radiologists and urologists. Clinical presentation occurs in the 3rd and 4th decades of life, manifesting mainly with flank pain. We present our experience in the diagnosis and management of CVU in a Nigerian Centre. A 56-year-old man presented with a 2-year history of recurrent, colicky right flank pain. He had been seen in multiple tertiary hospitals with no definitive diagnosis or treatment. A computerised tomography urogram showed an abnormally dilated proximal ureter with the classical fish-hook appearance and medial displacement, posterior to the IVC. At surgery, via an open, flank, extraperitoneal approach a CVU was found with significant stenosis and prestenotic dilatation. An excision of the stenotic segment with ureteroureterostomy was performed over a 6F D-J stent, and he had a smooth postoperative period. A CVU is extremely rare, and hence, the diagnosis can be missed. If left unattended, CVUs can progress to hydronephrosis and, eventually, a nonfunctioning right kidney. A high index of suspicion and early surgical intervention are key to a successful outcome.

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“…Its underhanded evolution is one of the main reasons why its diagnosis is often very late and sometimes post mortem. Although congenital, RCU usually becomes symptomatic in the third or fourth decade of life due to hydronephrosis from compression of the ureteral segment by the IVC against the psoas muscle, ureteral kinking or from an adynamic retrocaval ureteral segment [8] , [44] , [45] . RCU results in varying degrees of hydronephrosis and thus, in non-specific clinical presentation [17] .…”

Section: Discussionmentioning

confidence: 99%