Congenital and Acquired Disorders of Ureteral Course

A wide variety of entities can alter the course of the ureter in the abdomen and pelvis. These include conditions both intrinsic and extrinsic to the ureter leading to a number of different ureteral abnormalities including thickening, displacement, dilatation, etc. An understanding of ureteral pathology, as with any organ, first requires understanding of the normal anatomic appearance. The ureter can be evaluated in a number of ways, including radiographs, such as intravenous pyelogram and retrograde pyelogram, as well as computed tomography or magnetic resonance urography. The unopacified ureter can also be evaluated on examinations tailored for evaluation of other pathologic entities. Although the full spectrum of ureteral pathology is rather broad, this article serves as a review of the normal embryology and anatomy of the ureter, methods of evaluating the ureter at imaging, and entities that can alter the course of the ureter. These potential disorders of ureteral course include embryologic causes; surgical procedures; and displacement by inflammatory, neoplastic, and anatomic abnormalities.