病例報告：完全雙套集尿系統併輸尿管囊腫

羅偉恩、王曉暹、蔡昇翰、黃家倫、楊景偉、陳光國、張心湜、謝啟誠

振興醫療財團法人振興醫院泌尿部

Case Report: Complete Duplication of collecting system with ureterocele

Wei-En Luo, Hsiao-Hsian Wang, Sheng-Han Tsai, Chia-Lun Huang, Chin-Wei Yang, Kuang-Kuo Chen, Luke S. Chang, Chieh-Chen Hsieh

Department of Urology, Cheng Hsin General Hospital, Taipei, Taiwan

Case presentation: 

This is a case of a 30-year-old female suffered from fever, dysuria and left flank pain for one day.

She visited to our ER for help where leukocytosis with elevated CRP and pyuria were noted. Under the impression of left APN, the patient was admitted for further management. Further abdominal CT showed complete duplication of the left collecting system and ureter. The ureter from left upper renal moiety showed typical lower insertion at urinary bladder and remarkable dilation. Endoscopic examination showed a bulging mucosa at left lower neck suspect ureterocele, a small opening was noted. Unroofing of ureterocele was done. A wide orifice was found behind the ureterocele. After surgery and antibiotic treatment, the patient recovered well after the operation and had regular follow up at our outpatient department.

Discussion:

Duplication of 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. Surgical approach may include endoscopic decompression or reconstruction of the collecting system.