Presentation
Work up for hematuria.
Patient Data
Age: 35 years
Gender: Female
From the case:
Cobra head stone in duplex system ureterocele - bilateral
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In the non-contrast image, a few stones are seen in the left renal bed. The largest one is located at the upper pole.
Additionally, two stones are noted in the pelvis at the anatomical location of the urinary bladder.
In the post-contrast secretory phase, the urinary collecting system of both kidneys and ureters are duplicated. Local hydronephrosis is evident in the upper pole of the left kidney due to the stone.
The distal ureters bulge into the urinary bladder with the Cobra head sign, which suggests ureterocele. The two stones mentioned in the pelvis are each inside one of the ureteroceles.
Case Discussion
Bilateral Cobra head stones in duplicated collecting systems which is rare.
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