Obstructed upper pole ureter in a duplex kidney

Case contributed by Vaite Tsing
Diagnosis certain

Presentation

Presented with a palpable right abdominal mass and right colicky flank pain.

Patient Data

Age: 55 years
Gender: Male

Obstructed upper pole duplex component of the right kidney, with marked cystic dilatation of the right upper pelvicalyceal system and ureter with associated parenchymal atrophy. Complete duplication of the right kidney, upper moiety ureter insertion into the prostatic urethra. Conventional insertion of the lower moiety ureter into the trigone.

Incomplete duplication of the left kidney with union of the upper and lower moiety ureters at the level of the S2. Conventional insertion of the left ureter at the trigone.

Case Discussion

This patient presented with low grade symptoms of a chronically obstructed upper moiety in a duplex kidney. Clinically had a large palpable right abdominal mass. Imaging revealed a chronically obstructed upper moiety ureter with associated parenchymal atrophy. He later underwent a laparoscopic right heminephrectomy and excision of the entire dilated upper moiety ureter.

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