PT - JOURNAL ARTICLE AU - Kalpesh Mahesh Parmar AU - Shantanu Tyagi AU - Shrawan kumar Singh AU - Gopal Sharma TI - Rare case with plethora of upper urinary tract anomalies associated with pelviureteric junction obstruction: a surgical challenge managed with robot assistance AID - 10.1136/bcr-2018-228684 DP - 2019 Jan 01 TA - BMJ Case Reports PG - bcr-2018-228684 VI - 12 IP - 1 4099 - http://casereports.bmj.com/content/12/1/bcr-2018-228684.short 4100 - http://casereports.bmj.com/content/12/1/bcr-2018-228684.full SO - BMJ Case Reports2019 Jan 01; 12 AB - The genitourinary system for reasons unknown is more likely to have birth defects than any other system. The anomaly of collecting system draining the kidney represent mystifying subset of congenital anomalies. Pelviureteric junction obstruction (PUJO) is most common. Chronic obstruction can lead to stasis, urinary infection and stone formation in PUJO. Extrarenal calyces, which is characterised by presence of calyces and renal pelvis outside the renal parenchyma is one of the rare anomalies seen among the collecting system right gonadal vein drains into inferior vena cava. Its altered drainage into right renal vein is rarely seen and reported. Glut of these multiple anomalies in a single case is an extremely rare event. We hereby discuss a case of 40-year-old male patient with combination of all these anomalies and discuss the embryology, presentation and management.