Complete ureteric duplication with ureterocele

Case contributed by Dr Mostafa El-Feky

Presentation

Right loin pain

Patient Data

Age: 40 years
Gender: Female

The first delayed CT shows duplex right kidney. The lower moiety ureter is opacified until its insertion at the right vesicoureteric junction adjacent to fluid density sac-like structure (the upper moiety ureterocele). It ends at the same axial level as the left vesicoureteric junction.

The second delayed scan shows opacified upper moiety ureter until its ectopic insertion inferomedial to the right vesicoureteric junction with terminal dilatation forming a ureterocele. Mild dilatation of upper moiety and its ureter.

Normal left renal collecting system and ureter.

Incidental right ovarian cyst.

Case Discussion

Duplex collecting system is a common congenital anomaly of the urinary tract. This case shows the relationship of both moieties ureters according to Weigert-Meyer law, which states that:

  • upper moiety ureter has an ectopic insertion medial and inferior to the lower moiety ureter and ends in a ureterocele
  • lower moiety ureter has insertion lateral and superior to the upper moiety ureter - see the first axial delayed CT for relationship

See illustration here (rID:30185).

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