The unsuspected double collecting system on imaging studies and at cystoscopy

AJR. American Journal of Roentgenology
J C Share, R L Lebowitz

Abstract

Five children (three girls and two boys) who had a duplex collecting system with an ectopic ureter or a ureterocele that was not detected with either imaging or cystoscopy were seen during a 10-year period. Four had urinary tract infection. The fifth was noted to have hydronephrosis when CT scanning of the abdomen was done for trauma. In each case, voiding cystourethrography showed reflux into what was thought to be a single (nonduplex) collecting system, but was found during surgery to be the lower pole of a duplex system. Excretory urography in four patients, sonography in two, and CT scanning in one did not show signs of duplication on the affected side. In each case cystoscopy failed to show a duplex system on the affected side. The diagnosis of duplication of the collecting system with ectopic ureter or ureterocele was made in each case only when the bladder was opened to reimplant the ureter. Direct opacification of the previously unsuspected upper pole ureter in each case showed it to be bind-ending and terminating at the level of the kidney. Radiologists and surgeons should be aware that duplex systems may not always be visible on urography and sonography.

Citations

Mar 17, 2016·World Journal of Radiology·Subramaniyan RamanathanYegu Palaniappan
Nov 4, 2000·The Journal of Urology·V M Gylys-MorinC A Sheldon
Apr 1, 1996·The Journal of Urology·J G Corrales, J S Elder
May 1, 1997·International Journal of Urology : Official Journal of the Japanese Urological Association·N YanagisawaT Iwamoto
Nov 1, 1996·The Australian and New Zealand Journal of Surgery·P L KhongH Saing
Jul 1, 1994·The Journal of Urology·M A Daniels, T D Allen

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