Hungarian Radiology

[Difficulties in the diagnosis of ectopic ureter]

KONCZ Júlia1, RÉTI Gyula1, NYÁRI Edit2, SHAIKH M. Shoaib2

APRIL 07, 2009

Hungarian Radiology - 2009;83(01)

[INTRODUCTION - Ureter ectopy refers to the distal opening of the ureter at the site of the bladder neck or lower. 70-80% of the ectopic ureters are associated with pyelectasia and duplicated ureters. The incidence of this is 2-3 times higher in females. CASE REPORT - Following is a case report of a boy who was diagnosed with left-sided pyelectasia during a prenatal ultrasound scan. The postnatal ultrasound revealed a duplicated pelviceal cavity and ureter. The upper pole ureter and the pelvis demonstrated dilatation. At 8 months of age a left side heminehprectomy was performed. Two years postoperatively a follow-up ultrasound revealed a dilatation of the ureteral stump on the left side, which progressed. On MCUG the ureteral stump was identified inserting on to the proximal urethra. Cystography and MR urography demonstrated a ureteral stump which inserted on to the urethra. A repeat surgery was performed to remove the stump. Patient is symptom-free ever since. CONCLUSION - In ectopic, non-refluxing ureters long-term follow-up is necessary following heminephrectomy. A ureter stump besides the bladder can cause serious diagnostical difficulties. Also, it is possible that a dilating stump may lead to a reflux not identified earlier. MCUG and MR urography can help to clear delineate the pathology.]

AFFILIATIONS

  1. Borsod-Abaúj-Zemplén Megyei Kórház és Egyetemi Oktató Kórház, Gyermeksebészeti Osztály
  2. Borsod-Abaúj-Zemplén Megyei Kórház és Egyetemi Oktató Kórház, Képalkotó Diagnosztikai-Intervenciós Intézet

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Hungarian Radiology

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