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Case Report

Med Arch. 2011; 65(1): 58-60


Abnormal Insertion of Right Ureter Into the Left Ureter Associated with Absence of Normal Right Ureterovesical Junction

Ramë Miftari, Rubina Alagic-Alimanovic, Xhavit Bicaj, Zhaneta Shala, Idriz Gerqari, Adem Nura, Ismet Bajrami.




Abstract

Aim: There are lots of factors which cause the dilatation of one or both ureteres. Congenital absence of ureterovesical junction was reported as very rare cause of megaureter. Early detection of congenital absence of normal ureterovesical junction offers utilities for reconstruction and prevents the complications such as megaureter and vesicoureteral reflux. Material and methods: A male patient 16 months old was referred for renal DTPA scintigraphy confirmed previously with diagnosis as megaureter of left kidney associated with consecutive stasis grades III of the left ureter. Dynamic renal scintigraphy was performed after intravenously injection of 37 MBq Tc DTPA. Scintigraphy was carried out on a Dual Head-Siemens gamma camera using a high resolution collimator. During the dynamic scintigraphy patient was positioned in supine position. Results: Male patient 16 month old with vomiting, diarrhoea, fever, indolence during last two weeks were referred for dynamic renal scintigraphy. Meanwhile patient was also performed other laboratory tests such as: RBC= 4.07x1012, SRE= 47, Hb=111, Bun=5.2, Creatinine=29 and urine proteins ++. Examinations with Ultrasound, CXR and intravenously urography confirmed diagnosis of left megaureter associated with consecutive stasis Gr.III and Stasis of left kidney gr. I-II. With dynamic scintigraphy was confirmed the absence of right ureterovesical junction followed by joining of right and left ureter at the level of the lower part of the left ureter. Conclusion: Renal dynamic scintigraphy demonstrates abnormal insertion of right ureter into the left ureter associated with absence of normal right ureterovesical junction, right megaureter and with vesicoureteral reflux.

Key words: ureterovesical junction, megaureter, reflux.






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