case_images: PMC5011217_01
case_images: CT scan image showing the "reverse J" deformity.
case_images: CRIU2016-3591832.001.jpg
case_images: PMC5011217_01_CRIU2016-3591832.001.jpg
case_images: fig1
case_images: Computed tomography (CT) scan after contrast infusion showed right hydroureteronephrosis, with the classical "reverse J" or "fishhook" deformity suggesting the presence of a retrocaval ureter (Figure 1).
case_images: The renal pelvis after dissection.
case_images: CRIU2016-3591832.002.jpg
case_images: PMC5011217_01_CRIU2016-3591832.002.jpg
case_images: fig2
case_images: The classic operative steps were performed for exposure: reflection of the ascending colon medially, identification of the ureter, and dissection of the right renal pelvis (Figure 2).
case_images: Renal pelvis, proximal ureter, and retrocaval portion dissected and mobilized.
case_images: CRIU2016-3591832.003.jpg
case_images: PMC5011217_01_CRIU2016-3591832.003.jpg
case_images: fig3
case_images: Complete mobilization of the retrocaval portion of the ureter was achieved exposing its atretic and scarred portion (Figure 3).
case_images: Preparing for pyeloplasty after suspension of the renal pelvis.
case_images: CRIU2016-3591832.004.jpg
case_images: PMC5011217_01_CRIU2016-3591832.004.jpg
case_images: fig4
case_images: Previous to the reconstructive phase of the operation, we chose to suspend the renal pelvis to the anterior abdominal wall (passing a monofilament wire trough the renal pelvis and the abdominal wall with a straight needle), improving visualization and stabilization and dismissing the need for an "extra hand" (Figure 4).
case_images: Starting the anastomosis, first on the posterior side with running suture.
case_images: CRIU2016-3591832.005.jpg
case_images: PMC5011217_01_CRIU2016-3591832.005.jpg
case_images: fig5
case_images: The anastomosis was performed using 3-0 polyglactin sutures in a continuous, tension-free fashion (Figure 5).
case_images: Final look of the anastomosis after inspection.
case_images: CRIU2016-3591832.006.jpg
case_images: PMC5011217_01_CRIU2016-3591832.006.jpg
case_images: fig6
case_images: The anastomosis was finally inspected confirming water tightness (Figure 6).