EVALUATION OF URETERAL OBSTRUCTION IN THE BONY PELVIS WITH ILIAC VEIN VENOGRAPHY

¹ Assistant Professor, Albert Einstein College of Medicine.
² Professor, The New York University School of Medicine.

Evaluation of the iliac vein by venography has proven helpful in determining the etiology of obstructions of the ureter at the pelvic brim.

Seven cases demonstrating this relationship between ureter and iliac vein are presented. Obstruction of the ureter with corresponding iliac venous encroachment is thought to confirm the diagnosis of extrinsic involvement of these structures. A normal iliac venogram with an obstructed ureter would tend to rule out this possibility and be a helpful sign, pointing to primary ureteral pathology such as ureteral tumor, ureteral stricture or post surgical tie. If both ureter and pelvic veins are obstructed, a benign extrinsic etiology cannot be definitely excluded, although such an appearance is frequently due to malignancy.

In the course of this study, it was also observed, that obstruction of the iliac vein by tumor frequently is not associated with symptoms of venous obstruction due to the development of extensive collateral circulation.

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