Lower ureteric obstruction by crossing vessel - Is it possible?

Ureteral obstruction can occur due to various pathologies. Ureteral calculus is one of the commonest causes. Extra luminal and less commonly intra luminal Ureteral obstruction can occur due to malignancy. Unrecognised Ischemic injuries during gynaecological surgery can cause ureteric stricture and obstruction at a later date. Traumatic injuries have also been documented as an important cause of ureteric obstruction. Infections particularly Tuberculosis in the developing countries remains a significant cause. It is significant to note that there are very few cases of lower ureteric obstruction when compared to that of obstruction of upper ureter. Peri-ureteral fibrosis due to vascular causes like abdominal and iliac artery aneurysms has also been described uncommonly as causative. A detailed search of literature revealed only around ten cases of distal ureteric obstruction due to arterial vascular anomalies like persistent umbilical artery and umbilical ligament. Here in we describe a rare case of distal ureteric obstruction which we