WOFAPS 2025 8th World Congress of Pediatric Surgery

Aida el Gouacem, Sarra Chennouf

establishment mother child sidi Mabrouk Constantine

Background:

Retrocaval ureter (RCU) is an uncommon congenital anomaly resulting from an aberrant development of the inferior vena cava, leading to the ureter being trapped behind it. Although typically diagnosed in adults, pediatric cases are rare and may present with non specific symptoms such as intermittent flank pain or urinary tract dilation.

Case Presentation:

We report the case of a 12-year-old child who presented with intermittent right flank pain and no history of urinary tract infections. Abdominal ultrasound revealed right-sided hydronephrosis. Further evaluation using magnetic resonance urography confirmed a retrocaval course of the right ureter with obstruction proximal to the ureteropelvic junction. Renal function was preserved

Surgical Management

A laparoscopic transperitoneal ureteroureterostomy was performed. The retrocaval segment was excised, and the ureter was repositioned anterior to the inferior vena cava and re-anastomosed. A double-J stent was placed and removed after 6 weeks

Outcome

The postoperative course was uneventful. At 6-month follow-up, the child was asymptomatic, with complete resolution of hydronephrosis and no evidence of obstruction on follow-up imaging.

Conclusion

Although rare in the pediatric population, retrocaval ureter should be considered in cases of unexplained right hydronephrosis. Laparoscopic correction offers a safe, effective, and minimally invasive solution with excellent functional outcomes