Herniation of ureter into greater sciatic foramen

Case contributed by Dr Vikas Shah

Presentation

Intermittent left loin pain and non-visible hematuria. Cystoscopy and ultrasound normal.

Patient Data

Age: 60 years
Gender: Female
CT

CT abdomen and pelvis

Previous bowel surgery with colonic suture line. No renal masses or renal tract stones.

CT

Delayed phase CT

The left renal pelvis and ureter are distended, secondary to entrapment of the distal ureter within a left sciatic hernia (trapped within the greater sciatic foramen). There is no herniation of bowel. There is blunting of the calyces of the left kidney, but overall renal size is not reduced when compared to the right kidney.

CT

3D reconstructions

The 3D reconstructions from the delayed phase CT dataset show the abnormal path of the left ureter into the left greater sciatic foramen. This has been described as the curlicue ureter sign.

CT

3D reconstruction video

The 3D reconstruction from the delayed phase CT dataset show the abnormal path of the left ureter into the left greater sciatic foramen. This has been described as the curlicue ureter sign.

Case Discussion

The distal left ureter is trapped within a greater sciatic foramen hernia causing upstream obstruction. A conservative management path was followed.

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Case information

rID: 50402
Published: 4th Oct 2019
Last edited: 5th Nov 2019
System: Urogenital
Inclusion in quiz mode: Included

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