case_images: PMC10522493_01
case_images: (A) CT-scan image - axial, coronal and sagittal sections (C stands for left side renal cyst, U is dilated right proximal ureter located lateral and behind the IVC, A is aorta, s stands for the stone in the right proximal dilated ureter and I is inferior vena cava). (B) Intraoperative image of retrocaval ureter.
case_images: RRU-15-431-g0001.jpg
case_images: PMC10522493_01_RRU-15-431-g0001.jpg
case_images: f0001
case_images: He was then investigated with CT-Urography, which showed a horseshoe kidney with the isthmus fusing between the abdominal aorta and IVC, a left-side renal cortical simple cyst, and a right-side moderate hydroureteronephrosis, with the dilated proximal ureter running posterior to the IVC and containing a stone measuring 0.9 cm with a HU of 800, and the ureter progressed distally behind the IVC (Figure 1A).  IVC, as shown in Figure 1B After careful dissection of the ureter, it was divided distal to the curvature and mobilised anterior to the IVC. Intraoperatively, the stone was found to have migrated to the renal pelvis, and flexible ureterorenoscopy was used to remove the stone with a Dormia stone basket.
case_images: PMC10522493_02
case_images: (A) Abdominopelvic CT-scan - axial, sagittal and coronal section. (B) Retrograde pyelography showing the S-shaped retrocaval ureter. (C) Intraoperative image of retrocaval ureter.
case_images: RRU-15-431-g0002.jpg
case_images: PMC10522493_02_RRU-15-431-g0002.jpg
case_images: f0002
case_images: The delayed image was only taken until 15 min, which did not show contrast excretion to the collecting system (Figure 2A); hence, we did a retrograde pyelography, which shows the characteristic S-shaped ureter (Figure 2B).  The gerota's fascia was opened from the caudal region to find a retrocaval ureter, which has an aperistaltic segment running behind the IVC (Figure 2C).