A 15-yr old girl from Himachal Pradesh, who was suffering from ‘circumcaval ureter’, a complex and very rare congenital condition of the right kidney, recovered well after laparoscopic surgery at a Panchkula private hospital recently.
Giving details, Dr Neeraj Goyal, consultant Urologist & Kidney Transplant Surgeon at Alchemist Hospital, who performed surgery said that the patient had persistent pain in the right side of abdomen.
Shushila (name changed ) was in agony due to the pain that limited her day-to-day activities and she was not able to concentrate in her studies. When her parents consulted local doctor, she was told to have swelling in the right side of kidney, exact cause of which could not be ascertained and was advised to visit a tertiary care center, said Dr Goyal.
After detailed investigations and tests at Alchemist , she was found to have ‘circumcaval ureter’.
Dr Goyal explained that in this rare condition, the ureter draining the right side kidney and the inferior vena cava i.e. the largest blood vessel draining the blood back from lower half of body to heart, are entangled together. This condition which was first described in 1893, affects one in 1500-2000 people, said Dr Goyal.
He further explained that if there is pain and swelling in the kidney, surgical correction is only available treatment for this condition. If it goes un- diagnosed or does not get treated appropriately, it may cause permanent damage or loss of the kidney. It usually exists since the time of birth, however as the child grows, this entanglement of the ureter starts causing obstruction in the flow of urine from right kidney, he remarked.
During two and half hours complex laparoscopic surgery, this entanglement was corrected after excision of the narrow segment of the ureter. The surgery was totally bloodless and was performed using three small painless keyholes incisions in the abdomen, said Dr Goyal adding the girl was absolutely fine by the evening of operation and was discharged from hospital after 2-day of rest.