Retrocaval Ureter：Report of Two Cases and Literature Review

下腔靜脈後輸尿管－二病例報告及文獻回顧

10.6452/KJMS.200303.0127

林鴻裕(Hung-Yu Lin)；周以和(Yii-Her Chou)；黃書彬(Shu-Pin Huang)；李永進(Yung-Chin Li)；蔡秀男(Hsiu-Nan Tsai)；鄭皓碩(Hao-Shuoh Jeng)；黃俊雄(Chun-Hsiung Huang)

下腔靜脈後輸尿管；電腦斷層；核磁共振 ； retrocaval ureter；computerized tomography；MRI

The Kaohsiung Journal of Medical Sciences

19卷3期（2003 / 03 / 01）

127 - 131

英文

下腔靜脈後輸尿管為比較罕見之先天性異常，意指輸尿管臨到下腔靜脈後並被下腔靜脈壓迫。導因為下腔靜脈的異常胚胎發展結果導致在腰部的右側心下靜脈未萎縮。在此，本文報導二例下腔靜脈後輸尿管並回顧相關的文獻。個案一為7歲男孩有右腰疼痛，另一個案為40歲男性於身體檢查時，經超音波意外發現有右腎水腫。此二案例皆接受逆行性輸尿管腎盂攝影，並顯示出典型的“S”型態；再由電腦斷層和核磁共振確定為下腔靜脈後輸尿管。更進一步，個案經由輸尿管輸尿管重接手術，其組織病理的特徵顯示一位患者之輸尿管有局部鱗狀細胞化生，另一位則有慢性發炎和纖維化。術後追蹤顯示，水腫和腎功能皆有改善。下腔靜脈後輸尿管是少見的疾病，而手術通常是有療效的。

Retrocaval ureter is a rare congenital anomaly in which the ureter passes behind, and is compressed by, the inferior vena cava. Its etiology is assumed to be abnormal embryologic development of the inferior vena cava as a result of atrophy failure of the right subcardinal vein in the lumbar portion. We report two cases of retrocaval ureter and review the relevant literature. One patient was a 7-year-old boy who presented with right flank pain. The other was a 40-year-old male who was found to have right hydronephrosis accidentally on abdominal sonography during a health examination. Both underwent retrograde pyelography which showed the typical S-shape of a retrocaval ureter. Abdominal computerized tomography and magnetic resonance imaging confirmed the diagnosis of retrocaval ureter. Ureteroureterostomies were performed. One patient showed focal sq the ureter and the other had chronic inflammation and fibrosis. Follow-up studies showed improvement in hydronephrosis and renal function in both patients. We conclude that retrocaval ureter is a rare disorder and surgical correction is usually effective.