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A 15-year-old Emirati boy has been successfully treated at Al Ain’s Burjeel Farha for retrocaval ureter – a rare congenital condition with fewer than 200 cases being reported worldwide in over 100 years.
For months, Abdulla Ali Abdulla Alblooshi had been experiencing abdominal pain but had not received a definitive diagnosis until recently. After a successful surgical procedure, he is now discharged and on the path to pursuing his dreams in sports.
A gifted sportsperson, his accomplishments span across marathons, golf, and football. He clinched first place in the ADNOC Marathon and came second in the UAE President’s Cup 2023 Future Falcon Championship. The teenager considers football icon Lionel Messi as his role model and hopes to play like UAE’s prolific goal scorer Ali Mabkhout. The Grade 11 student wishes to represent the UAE at the Olympics and win a medal for his beloved country.
However, he had been battling abdominal pain because of the retrocaval ureter, which had gone undetected for years. His parents Ali Abdulla Mohammed Alblooshi and Zaynab Mohammed Adam Alblooshi told Khaleej Times, the journey to the diagnosis was a challenging one.
As Abdullah’s pain started intensifying in February and he began experiencing nausea, they made multiple visits to doctors, but nobody could pinpoint the cause and the pain was attributed to other factors.
“He used to experience sharp shooting pains. In the initial stages, the pain only lasted for 2-3 minutes but gradually the duration increased to 10-15 minutes. Abdullah is very passionate about sports. It finally got to a point when the pain started interfering with his daily activities, including school and sports,” said Zaynab.
In September, they consulted Dr Humam Qaraschouli, consultant urologist at Burjeel Farha, who ran tests, including ultrasound and CT scan.
“The ultrasound showed the right kidney was becoming dilated. Initially, we suspected ureter stones and to confirm the diagnosis a CT-scan of the abdomen was done. We discovered that Abdullah has a congenital anomaly of the right ureter (the tube that carries urine from the kidney to the bladder).”
Dr Humam noted that a retrocaval ureter is a rare congenital anomaly most commonly affecting the right ureter. It has a worldwide incidence of 0.06 to 0.17 per cent with little more than 200 cases reported since 1893.
“Usually, people with this condition get extreme pain and are diagnosed when they go for a scan. But paediatric reports of this condition are rare,” said Dr Humam.
A retrocaval ureter occurs when a segment of the ureter wraps around the vena cava inferior – a major vein that carries blood back to the heart. This unusual positioning of the ureter can lead to urinary obstruction and severe pain. In Abdullah’s case, the condition also affected the functioning of his right kidney.
Abdullah’s parents were taken aback by the diagnosis and worried when the doctor suggested surgery to correct the position of his ureter. “I have been working with the Abu Dhabi Police for so many years. So, I always insisted my kids play sports and stay physically active. So, when Abdullah was diagnosed with this condition, we were shocked that we failed to identify this problem our son had for years,” Zaynab said.
Despite their worries, they placed their faith in the Almighty and asked Dr Humam to proceed with the surgery. Dr Humam resected the right ureter and repositioned it correctly. He then reconnected both segments of the ureter. To facilitate proper healing and drainage, a ureter stent was inserted, which will be removed after a few weeks.
Dr Humam noted that retrocaval ureter often goes unnoticed for a long time.
“In this case, timely surgical intervention was crucial in relieving Abdullah’s suffering and preventing potential complications. We are pleased that the procedure went smoothly, and that he is now on the road to recovery.”
With his health restored, Abdullah is now eager to resume his education and pursue his athletic dreams. “I was on sick leave from school most of the days during this year. I am thankful to the medical team who helped me overcome this challenging condition. I am happy and feel much better now. I can’t wait to get back to school and my athletic pursuits,” said Abdullah.
According to Dr Humam, cases like these are reminders of the importance of correct diagnosis, especially for conditions that may mimic other common ailments. “When children keep having recurrent abdominal pain, it is good to do an ultrasound to get the correct diagnosis. Ultrasounds are not invasive and can help rule out abnormalities.”
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