PMC4294447_01
IVU showed findings compatible with a sciatic ureter, a dilated left ureter with a fixed kinking. The diagnosis was confirmed by this image, known as the 'curlicue' sign, which is considered pathognomonic for ureterosciatic herniation.
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F1
Intravenous ureterography (IVU) showed findings compatible with a left sciatic ureter, a dilated ureter with a fixed kinking, which is known as 'curlicue' sign (fig. 1).
Axial CT scan of the pelvis showing marked hydroureter on the level of the sciatic notch and the passage of the left ureter through the greater sciatic foramen posterior to the ischium, consistent with sciatic ureter.
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F2
The abdominal CT showed marked hydronephrosis and hydroureter on the level of the pelvic inlet and revealed the presence of a sciatic herniation of the ureter (fig. 2).
a Retrograde pyelogram showing curlicue formation as the left ureter passes into the sciatic notch, demonstrating left ureterosciatic hernia. b-d The ureterosciatic hernia was relieved with the passage of a flexible guide wire and a double-pigtail ureteral stent.
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F3
Retrograde pyelography demonstrated hydronephrosis with 'curlicue' formation of the distal ureter (fig. 3a). Interestingly, the ureterosciatic hernia was relieved with the passage of a flexible guide wire and a double-pigtail stent (fig. 3b-d).