ureteric filling defect from a vena caval clip

BJU International (1999), 83, 351–352 CASE REPORT Ureteric filling defect from a vena caval clip C.M. GONZALEZ andW.A. COOK Department of Urology, Northwestern University Medical School, Chicago, IL, USA Rigid ureteroscopy revealed no evidence of ureteric Case report irregularity but there was narrowing of the ureter at the level of the filling defect. Cytology, brushings and culture A 48-year-old woman presented with persistent micro- scopic haematuria but denied any constitutional symp- were unremarkable for carcinoma, infection or tubercu- losis. CT with (Fig. 3a) and without (Fig. 3b) contrast toms or flank discomfort. The patient had passed a mixed calcium and uric acid stone 6 months previously. She was used to confirm an Adams-DeWeese vena caval clip impinging on the right ureter as the cause of the filling had a remote history of recurrent lower extremity deep venous thrombosis which required a vena caval clip in defect. The patient remains asymptomatic at 6 months of follow-up. 1973. A physical examination and serum chemistry were normal; her urinary pH was 5.0 and urine culture was negative for bacterial growth. IVU revealed a filling Comment defect of the right proximal ureter and she was started on oral alkalinization. Repeat IVU 6 weeks later revealed Before endoluminal filters, transabdominal vena caval clip placement was used for caval interruption. These the same right ureteric filling defect (Fig. 1). Subsequent cystoscopy was normal with a bilateral retrograde pyelo- Teflon clips are both safe and eCective in preventing pulmonary embolism in high-risk patients [1]. This is gram confirming the right ureteric filling defect (Fig. 2). Fig. 2. Right retrograde pyelogram confirming the ureteric filling Fig. 1. IVU showing the right proximal ureteric filling defect. defect. 351 © 1999 BJU International

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Page 1: Ureteric filling defect from a vena caval clip

BJU International (1999), 83, 351–352

CASE RE PORT

Ureteric filling defect from a vena caval clipC.M. GONZALEZ and W.A. COOKDepartment of Urology, Northwestern University Medical School, Chicago, IL, USA

Rigid ureteroscopy revealed no evidence of uretericCase report

irregularity but there was narrowing of the ureter at thelevel of the filling defect. Cytology, brushings and cultureA 48-year-old woman presented with persistent micro-

scopic haematuria but denied any constitutional symp- were unremarkable for carcinoma, infection or tubercu-losis. CT with (Fig. 3a) and without (Fig. 3b) contrasttoms or flank discomfort. The patient had passed a mixed

calcium and uric acid stone 6 months previously. She was used to confirm an Adams-DeWeese vena caval clipimpinging on the right ureter as the cause of the fillinghad a remote history of recurrent lower extremity deep

venous thrombosis which required a vena caval clip in defect. The patient remains asymptomatic at 6 monthsof follow-up.1973. A physical examination and serum chemistry

were normal; her urinary pH was 5.0 and urine culturewas negative for bacterial growth. IVU revealed a filling

Commentdefect of the right proximal ureter and she was startedon oral alkalinization. Repeat IVU 6 weeks later revealed Before endoluminal filters, transabdominal vena caval

clip placement was used for caval interruption. Thesethe same right ureteric filling defect (Fig. 1). Subsequentcystoscopy was normal with a bilateral retrograde pyelo- Teflon clips are both safe and eCective in preventing

pulmonary embolism in high-risk patients [1]. This isgram confirming the right ureteric filling defect (Fig. 2).

Fig. 2. Right retrograde pyelogram confirming the ureteric fillingFig. 1. IVU showing the right proximal ureteric filling defect. defect.