Appearances of the circumcaval ureter on excretory urography and MR urography: A single-center case series
A 43-year-old man presented with flank pain for 2 months. Sonographically, there was right-sided hydronephrosis. IVU showed a dilated pelvis and proximal ureter, with grade 3 hydronephrosis. Retrograde Pyelogram (RGP) was performed, which showed only the distal normal ureter, up to L4 vertebral level, the tip of the catheter being more medial than expected, causing circumcaval ureter to enter the differential. CT was performed to exclude radiolucent calculus, and the proximity of the ureter and IVC was noted, though there was no retrocaval segment. MRU was performed, and though the procedure had to be terminated prematurely owing to the patient's claustrophobia, the obtained sections excluded a circumcaval course of the ureter and were suggestive instead of a crossing vessel []. The latter was proven intraoperatively a week later.