Retrocaval ureter: a case report and review of the literature.

Background: The retrocaval ureter is a rare congenital anomaly resulting from abnormal development of the inferior vena cava. The obstruction is usually at the retrocaval segment of the ureter, as it lies between the inferior vena cava and the body of the third lumbar vertebra. Computed tomography intravenous urography is the gold standard for investigating this condition and can reveal ipsilateral hydronephrosis and the fishhook sign or sickle sign of the proximal ureter, depending on the type of retrocaval ureter.

Case presentation: We present the case of a 30-year-old African female who presented with intermittent dull right flank pain for 3 years. Computed tomography intravenous urography revealed isolated moderate right hydronephrosis with a fishhook sign in the proximal ureter. Surgical correction was performed, and the patient was followed for 6 months with improved renal function.

Conclusion: Surgery remains the sole definitive management of the retrocaval ureter for symptomatic patients and those with worsening hydronephrosis or differential renal function.