Transcaval Ureter: A Rare Embryological Anomaly of Inferior Vena Cava Causing Obstructive Uropathy

Transcaval ureter is a rare condition caused by abnormality in the embryogenesis of the inferior vena cava (IVC). It results from a segmental duplication of the IVC which creates a venous ring that encircles the right ureter. Here, we report a case of a 42-year-old female who presented to us with a history of right flank pain for 2 years. Ultrasonography, intravenous urogram, and contrast-enhanced computed tomography (CECT) scan of the abdomen suggested it to be a retrocaval ureter. On exploration, contrary to the report of imaging, the ureter was found to transverse in between two segments of IVC and thus on table, a diagnosis of the right transcaval ureter as the cause of obstruction was made. The patient underwent segmental ureteral resection followed by ureteroureterostomy. Follow-up CECT scan was done to document two segments of IVC and thus confirm our intraoperative finding.