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[Evading the catastrophy].

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Summary
This summary is machine-generated.

A young woman experienced flank pain due to a rare retrocaval ureter. Misdiagnosis led to multiple treatments before considering endoscopic endopyelotomy for ureteral obstruction.

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Area of Science:

  • Urology
  • Anatomy

Context:

  • A 21-year-old athletic female presented with recurrent flank pain.
  • Symptoms were exacerbated by fluid intake post-exercise.
  • Initial urological work-up revealed hydronephrosis and ureteral abnormalities.

Purpose:

  • To describe a challenging case of a retrocaval ureter.
  • To highlight diagnostic difficulties and therapeutic interventions for ureteral obstruction.

Summary:

  • The patient exhibited a "fishhook" ureter with medial displacement, indicative of a retrocaval ureter.
  • Despite ureterorenoscopy, biopsy, and endoscopic-radiology, the diagnosis was missed.
  • Repeated interventions including DJ stent placement and balloon dilatation were performed without resolution.

Impact:

  • This case underscores the importance of considering rare anatomical variations in diagnosing ureteral pathologies.
  • It emphasizes the limitations of standard diagnostic tools and the need for advanced endoscopic techniques like Acucise for definitive treatment.