Laparoscopic Ureteral Reconstruction in Children with Retrocaval Ureter: A Modern Single Center Retrospective Study.

Purpose: This study aims to report our experience in the treatment of children with retrocaval ureter (RCU) using laparoscopic ureteral reconstruction surgery. Patients and Methods: We retrospectively collected clinical data from 10 pediatric patients with RCU who underwent laparoscopic surgery at our hospital from April 2010 to April 2022. All patients underwent comprehensive preoperative radiological assessment and were diagnosed with RCU, subsequently undergoing laparoscopic ureteral reconstruction. Patient demographics, surgical data, and postoperative outcomes were recorded. Regular follow-ups were conducted postoperatively, evaluating clinical symptoms and radiological results. Results: The median age of the 10 patients was 8.8 years (range, 6-14 years). All surgeries were successfully performed laparoscopically without the need for open conversion, with an average surgical time of 153.3 minutes (range, 120-243 minutes). Intraoperative bleeding was minimal and no blood transfusions were required. No intraoperative complications were observed. The average hospital stay for the patients was 5.3 days (range, 4-7 days) and the Double-J (D-J) stent was removed 6 weeks postoperatively. Follow-up ultrasound results at 3 and 6 months postoperatively showed a reduction in renal pelvic dilatation, and all patients experienced significant relief of clinical symptoms related to flank and abdominal discomfort. Conclusion: Laparoscopic reconstruction for RCU demonstrates good feasibility and effectiveness in pediatric patients, offering a minimally invasive treatment option for the management of RCU in children.

Levopositioned caudal vena cava and circumcaval left ureter with subsequent hydronephrosis and hydroureter in a dog.

The presentation and investigation of a levopositioned caudal vena cava, a rare congenital vascular abnormality seen mainly in Bernese Mountain Dogs, which resulted in ureteral compression, hydronephrosis and hydroureter. Surgical transection, transposition and anastomosis were performed to reposition the circumcaval ureter. A 19-month-old male neutered Bernese Mountain Dog was presented with a 13-month history of vague signs including intermittent abdominal pain, inappetence and diarrhoea, which were poorly responsive to medical management. Abdominal ultrasound revealed left-sided hydronephrosis and hydroureter. Further investigation included abdominal computed tomography and pre- and post-intravenous iodinated contrast, which revealed a levopositioned caudal vena cava with associated ureteral displacement to a circumcaval position, resulting in ureteral compression and proximal dilation affecting both the proximal ureter and the left kidney. The patient was also found to have concomitant gall bladder agenesis. Surgery was performed to transect, transpose and anastomose the ureter in a normal anatomical position, and the patient made an excellent clinical recovery. All gastrointestinal signs resolved within 2 weeks of surgery and remained resolved 12 months later. Follow-up ultrasound and pyelography were performed at 4-month post-surgery, revealing a mild improvement in the hydronephrosis and hydroureter. Although rare, circumcaval ureter should be considered a differential in dogs presenting with hydroureter and hydronephrosis, especially Bernese Mountain Dogs.

Retrocaval Ureter With Ureteric Stones: A Case Report.

The retrocaval ureter is an uncommon anomaly where the ureter passes behind the inferior vena cava. Open surgery had been the gold standard for treatment. We are presenting a case of the retrocaval ureter with ureteral calculi, which was effectively managed by open surgery. A 27-year-old male presented with a nine-month history of flank pain. He had no history of chronic illnesses. Physical examinations and laboratory findings were within normal. A computed tomography (CT) scan was done to confirm the diagnosis of retrocaval ureter with ureteral stones. The subcostal incision was made. Then, the proximal and lower ureter was transected at the point where it went retrocaval. The stones were extracted; then, watertight anastomosis was done. Ultrasound used for the follow-up of the patient for six months showed no hydronephrosis. Retrocaval ureteral may have no symptoms or be linked to nonspecific symptoms. The diagnosis of the retrocaval ureter is frequently delayed. Surgical management is utilized in the majority of cases.

Robotic excision of a retrocaval ancient schwannoma: a case report.

We report a case of a robotic-assisted excision of a retrocaval ancient schwannoma. A 40-year-old female presented with generalized weakness and abdominal pain that led to the diagnosis of a retroperitoneal mass adjacent to the pancreas and inferior vena cava. Because of the clinical, imaging, and needle biopsy findings, the patient underwent an elective robotic-assisted retroperitoneal exploration. We provide an overview of the pathology and highlight the significance of utilizing a minimally invasive approach for excision of retroperitoneal masses.

Schwannoma retroperitoneal como diagnóstico diferencial de tumor retrocavo, reporte de un caso

Introducción: Los schwannomas suelen ser tumores benignos con origen en el sistema neural que sostiene la célula de Schwann. La mayoría presentan síntomas abdominales inespecíficos. Dado su escasa frecuencia, 1-5% de todos los tumores retroperitoneales en la población mundial, se presenta el siguiente caso. Pueden tener múltiples localizaciones, como el páncreas, tracto gastrointestinal y espacio retroperitoneal. Son pocos los casos que se han reportado siendo apenas notificados menos de 150 casos a la actualidad. Caso Clínico: Paciente femenina de 33 años con dolor abdominal inespecífico. Niega antecedentes relevantes y no presenta hallazgos positivos al examen físico. Estudios complementarios con tomografía y resonancia magnética nuclear de abdomen contrastados mostraron una masa retroperitoneal quística de 5x4 cm de localización suprarrenal derecha, que desplazaba la cava retrohepatica y que realza con medio contraste intravenoso. Debido a que el dolor era incapacitante se realizó resección quirúrgica. No se consideró biopsia preoperatoria, ante el riesgo de ruptura y diseminación tumoral. Se realizó escisión transperitoneal con resección completa, técnicamente compleja por su localización. El reporte histopato-lógico fue Schwannoma, sin tejido supra-adrenal, sugiriendo lesión yuxta-adrenal.

Introduction: Schwannomas are usually benign tumors originating in the neural system that supports the Schwann cell. Most have nonspecific abdominal symptoms. Given its low frequency, 1-5% of all retroperitoneal tumors in the world population, the following case is presented. They can have multiple locations, such as the pancreas, gastrointestinal tract and retroperitoneal space. Few cases have been reported, with less than 150 cases reported to date. Clinical Case: 33-year-old female patient with nonspecific abdominal pain. She denies relevant history and has no positive findings on physical examination. Complementary studies with contrast-enhanced tomography and magnetic resonance imaging of the abdomen showed a 5x4 cm cystic retroperitoneal mass located in the right suprarenal region, displacing the retrohepatic vena cava and enhancing with intravenous contrast medium. Because the pain was incapacitating, surgical resection was performed. A preoperative biopsy was not considered, given the risk of rupture and tumor dissemination. Transperitoneal excision was performed with complete resection, technically complex due to its location. The histopathological report was Schwannoma, without supra-adrenal tissue, suggesting a juxta-adrenal lesion.

Uréter retrocavo e infección recurrente de vías urinarias: A propósito de un caso / Retrocaval Ureter and Recurrent Urinary Tract Infection: Case Report

El uréter retrocavo es una anomalía poco frecuente de etiología congénita, la cual causa sintomatología en pacientes adultos; se caracteriza por hidronefrosis en diferentes grados, además de otras patologías relacionadas con lesión renal. El abordaje terapéutico es principalmente quirúrgico y se aplicará de acuerdo con el grado de disfunción renal. A continuación se presenta el caso de una mujer de 27 años de edad, a quien se le practicó un estudio imaginológico por infección recurrente de vías urinarias que no respondió a la farmacoterapia habitual.

Retrocaval ureter is a rare anomaly of congenital etiology, which causes symptoms in adults and is characterized by hydronephrosis in different degrees, in addition to other diseases related to renal injury. The therapeutic approach is mainly surgical and decided according to degree of related renal dysfunction. We present a case of a woman aged 27 who is sent to the radiology service of Hospital San Rafael Tunja for an imaging study after refractory urinary tract infection that did not respond to standard drug therapy

Retrocaval ureter and contra lateral renal agenesis – a case report and review of literature

ABSTRACT Associated congenital anomalies are seen in 21% of retrocaval ureter patients; among them, associated contralateral renal agenesis is a very rare entity. We report one such case of right circumcaval ureter with left renal agenesis, diagnosed after febrile UTI. Surgical correction with uretero-ureterostomy was successful. In literature very few such cases are reported and only one case with renal failure was reported. Unilateral renal agenesis cases complicated by associated such anomalies need definitive management and lifelong clinical monitoring to diagnose and prevent chronic kidney disease.

Ureter retrocava: relato de caso / Retrocaval ureter: a case report

Relata-se o caso de um paciente com ureter retrocava, diagnosticado inicialmente em exame de urografia excretora e confirmado com tomografia computadorizada do abdome. A tomografia computadorizada torna-se necessária não apenas para confirmar a posição do ureter em relação à veiacava inferior, como também para excluir outras doenças que cursam com hidronefrose, pois hidronefrose é o principal achado do ureter retrocava sintomático.

The authors report a case of a patient with retrocaval ureter found out in an excretory urography and confirmed with abdominal computerized tomography. The computerized tomography is necessary to confirm the position of the ureter and to exclude other diseaseswhich are associated with hydronefrosis, the main imaging finding,when there is a symptomatic retrocaval ureter.