A Case of Complete Pyeloureteral Duplication With Renal Atrophy at the Right Lower Pole

Abstract

Pyeloureteral duplication is often associated with atrophy of the upper pole of the kidney. We report a rare case of complete pyeloureteral duplication with renal atrophy at the right lower pole. The patient was an eight-year-old girl who had repeated unexplained fever and febrile convulsion from 2 to 3 years of age and was found to have bilateral pyeloureteral duplication by abdominal contrast-enhanced computed tomography when she had another convulsion. Abdominal ultrasound and renal scintigraphy showed severe atrophy in the right lower half of the kidney. Voiding cystourethrography (VCG) showed vesicoureteral reflux (VUR). Cystoscopy and retrograde cystourethrography showed that the medial and caudal orifice in the bladder and the lower renal moiety ureter to the lateral and cranial orifice according to the Weigert-Mayer law. VUR to the right lower kidney was observed. She underwent retroperitoneoscopic resection of the right lower half of the kidney and the affiliated ureter. Six months after the surgery, VCG showed no VUR. She had no symptoms during the period of two years after the surgery.