US and MDCT findings in a caudal blind ending bifid ureter with calculi

Blind-ending Bifid Ureter - A Case Report of Rare Congenital Anomaly and its Sonographic Appearance

AIM OF THE STUDY

We report a case of a blind-ending bifid ureter in a 67-year-old woman with ascites initially diagnosed with B-mode and Color Doppler ultrasonography and afterwards verified with contrast-enhanced abdominal computed tomography. A literature review of the pathogenesis, sonographic appearance with differential diagnoses and clinical significance is also presented and discussed.

CASE DESCRIPTION

The patient was referred for an abdominal ultrasound due to enlarged abdomen circumference. Ultrasound revealed signs of chronic pancreatitis with cavernous transformation of the portal vein and large ascites resulting in bilateral pelvicalyceal system dilatation. Additionally, we have preliminarily diagnosed right-sided, dilatated blind-ending bifid ureter with associated contralateral complete duplication of the ureter and the collecting system. These findings, initially revealed with ultrasound, were confirmed with contrast-enhanced abdominal computed tomography.

CONCLUSIONS

To our knowledge, this is the first detailed description of sonographic appearance of blind-ending bifid ureter.

A Novel Technique for Management of Simultaneous Fibro-Epithelial Polyp and Blind-Ending Branch in a Duplicated Ureter: A Case Report With 23-year Follow-Up

Ureteral duplication with a blind-ending branch (BEB) is rare anomaly. The presence of fibro-epithelial polyps in duplicated ureters is also infrequent. Despite the noticeability of endoscopic polypectomy, further recurrence of polyps and persistence of pain increase the probability of further ureteral resection with surgical procedures. In such cases, BEB of duplicated ureter is an excellent reservoir to save the function of the kidney. This is the first case with concomitant presence of fibro-epithelial polyps and BEB in duplicated ureter managed with novel surgical technique of uretero-pelvic junction and BEB branch anastomosis. We followed-up the patient for 23 years.

Bifid ureter with blind-ending branch: A rare anatomic variant detected during antegrade ureteric stent insertion

Anatomic variants of the urinary tract are relatively common; however, a bifid ureter with a blind-ending branch is a rare congenital anomaly. This variant often goes unnoticed because patients are either asymptomatic or complain of vague abdominal symptoms. Diagnosis is often incidental, and may be missed on conventional imaging. Although bifid ureters usually do not require any specific investigations or treatment; it is important to have an appreciation for these anomalies particularly if radiological intervention or surgical procedures are planned. We describe a case of a blind-ending bifid ureter in a patient with bilateral hydronephrosis secondary to a large cervical malignancy. The presence of the bifid ureter was only appreciated during a technically challenging antegrade ureteric stent insertion several weeks after diagnosis. We review the clinical significance, embryology, and radiology findings of this anomaly, as well as the implications during radiological interventional procedures.

Ureteral Stone Associated With a Middle Blind Ending of a Bifid Ureter

A blind-ending bifid ureter is an anatomic variant of ureteral duplications. There are three forms of blind-ending bifid ureter, classified depending on their location. A proximal blind-ending bifid ureter is the most common subtype of this congenital anomaly. Most patients are asymptomatic and only show symptoms after the complication has occurred. These complications include stone formation, vesicoureteric reflux, and ureteral tumor. Intravenous urography is usually used to diagnose bifid ureter; voiding cystourethrography, photofluoroscopy, cineroentgenography, cystoscopy with retrograde pyelography, computed tomography (CT), multidetector CT, and magnetic resonance urographies are other imaging methods used. This is a case of a ureteral stone associated with a middle blind ending of a bifid ureter.