2010 Volume 46 Issue 7 Pages 1130-1135
A 4-month-old boy was admitted to our hospital because of a high fever and was diagnosed with a urinary tract infection. Ultrasound and contrastenhanced computed tomography showed bilateral hydronephrosis. A voiding cystourethrogram showed bilateral vesicoureteral reflux, but the right renal pelvis was not detected. Although antibiotics were administered, a high white blood cell count and C-reactive protein level persisted. After a right percutaneous nephrostomy was constructed, the urinary tract infection was improved immediately; an antegrade pyelography showed right proximal ureteral stricture. Above all, a surgery for right proximal ureteral stricture was planned. Intraoperative findings indicated a retrocaval ureter, and a dismembered pyeloplasty was performed. However, urinary tract infection recurred one month later, so we also performed surgery for bilateral vesicoureteral reflux. After the second surgery, urinary tract infection did not recur. The incidence of symptomatic retrocaval ureter in children is low because hydronephrosis progresses very slowly. Our patient was suffering from a urinary tract infection because he also had bilateral vesicoureteral reflux that enabled the diagnosis of retrocaval ureter, which is very rare in infants.
