Presentation
Work up for mild right-sided hydronephrosis was reported on a recent ultrasound evaluation.
Patient Data
Mild hydronephrosis is present on the right side. The proximal portion of the right ureter is also mildly dilated, and the right ureter passes behind the IVC at the level of the L3 vertebra causing fishhook-shaped deformity. The ureter exits medially between the IVC and the aorta, then appears normal in caliber.
No renal or ureteral stones are noted bilaterally.
Case Discussion
Features are compatible with the retrocaval ureter, considered a developmental anomaly of the inferior vena cava.
IVU or CT-IVU classically depicts a fishhook-shaped deformity of the ureter in type 1, a low loop variety.
In type 2 or high loop variety, the retrocaval segment is at the same level as the renal pelvis, causing a sickle-shaped appearance that generally causes mild hydronephrosis and is less common than type 1.
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