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Double- J (JJ) stents are commonly used in urological procedures. Minor and self limiting complications are common following JJ stenting. Malpositioning of JJ stent into the vascular system is a rare and a possibly fatal complication. We are reporting a case of a malpositioned JJ stent in the inferior vena cava (IVC), during Boari flap procedure for post-hysterectomy uretereovaginal fistula. Patient had undergone hysterectomy three months previously, and had ureterovaginal fistula possibly due to iatrogenic intraoperative injury. Patient underwent right-sided ureteroneocystostomy with Boari flap one week previously at other institute. Patient was admitted in our institution with complaints of fever, pain in abdomen and vomiting. In view of the symptoms of the patient, cross-sectional imaging with computed tomography scan was done which revealed an intraoperatively malpositioned JJ stent in the IVC, and well healed Boari flap was seen.

Black pearl in urology: Inadvertent anastomosis of gonadal vein to ureter leading to malpostioning of stent into the inferior vena cava