下大静脈後尿管の2例について

Abstract

Two cases of retrocaval ureter were reported and the literature was reviewed. Case 1: The patient was a 41-year-old man who visited our clinic because of right flank dull pain. Physical examination and all laboratory data were within normal limit, but IVP showed right hydronephrosis with dilated ureter and a right ureteral stone. Retrograde pyelography and venacavography revealed distinctive hook of the ureter which encircled the inferior vena cava. The diagnosis of right retrocaval ureter was confirmed and the patient was surgically cured by uretero-ureteric anastomosis. Case 2: A 24-year-old man was admitted with the chief complaint of macrohematuria and lower abdominal pain. Although physical findings revealed tenderness of left flank, all laboratory data were within normal range. IVP showed a left ureteral stone and right hydroureteronephrosis. Right retrograde pyelography and venacavography revealed the same findings as case 1. Under diagnosis of right retrocaval ureter, the inferior vena cava was severed and reanastomosed after restoring the ureter to its normal course. This case was the fourth in Japan by such type of surgery. 109 cases of retrocaval ureter reported in Japan were reviewed and statistically discussed about its diagnosis and management.