Ureteral Entanglement in Ring Inferior Venacava- A Rare Presentation

Ureteral entanglement in ring Inferior Venacava (IVC) also called Periureteric venous ring is a rare developmental anomaly, where right ureter passes through a slit like opening in a partially duplicated infrarenal IVC, this results in a dilated upper urinary tract. Authors hereby report a case of a 25-year-old married female presented with flank pain of right side of abdomen for seven months. On Contrast Enhanced Computed Tomography of Kidney, Ureters and Bladder (CECT KUB) with urography diagnosed as retrocaval ureter with right hydronephrosis. The patient was planned for right ureteroureterostomy. During surgery, it was found that right ureter was entangled in between slit like opening of inferior venacaval ring. Preureteral venacava with ring IVC is a rare phenomenon. Clinically it is very difficult to distinguish between the causes of ureteric obstruction. There is scarcity of such cases in the literature. The index case was also diagnosed intraoperatively and managed successfully.