Retrocaval Ureter in a 7-Year-Old Girl Causing Symptomatic Unilateral Hydronephrosis- A Rare Case Report

Retrocaval ureter is a rare congenital anomaly in which the proximal ureter courses posterior to the inferior vena cava (IVC), potentially causing obstruction. It predominantly affects males (M: F ratio 4:1) and usually presents in the third or fourth decade of life. Presentation in young females, especially children, is exceptionally uncommon; this case is reported along with a review of the literature. We report a 7-year-old girl with recurrent right flank pain and no abnormal findings on physical examination. computerised tomographic (CT) urography demonstrated moderate right hydronephrosis with a characteristic “J”-shaped ureteral deformity on coronal images, confirming retrocaval ureter. Surgical management included ureteral division near the renal pelvis, pre-caval transposition, and pyeloureteric anastomosis over a double-J stent. The postoperative period was uneventful, and the patient was discharged in good condition. This case emphasises retrocaval ureter as an important differential diagnosis in paediatric patients with unexplained or persistent unilateral flank pain or hydronephrosis.