Left Pyelic Bifidity and Ectopic Ureteral Superolateral Intravesical Homolateral Ectopic Junction Revealed by a Urinary Calculus Apropos of a Case at the Pasteur Clinic

Abstract

Introduction: Malformations of the excretory tract are abnormalities due to a disorder of embryogenesis. According to some authors, their frequency varies from 0.30 to 5.25 per 1000. The aim of this study was to highlight the CT uroscan aspect of pyelic bifidity with intravesical ureteral ectopic junction revealed by a urinary calculus and to explain the interest of CT uroscan in the management of urinary pathologies. Result: We report the observation of a 37-year-old overweight patient with a body mass index equal to 28, a history of surgery and extracorporeal litho-thipsis dating back 10 years. He was referred to the Imaging Department in the context of renal colic. The uroscanner made it possible to highlight a left pyelic bifidity associated with an ectopic abutment of the left ureter on the superolateral wall of the bladder, a calculation in the left ectopic ureteral meatus measured at 4 mm in axial diameter. He noted upstream of these lesions, a uretero-pyelo-calicielle dilation on double homolateral pyelon. On late cuts, a slight delay in left renal excretion was noted. The right kidney was also the site of a hyperdense calculation of 1257 HU density and measured 4 mm in transverse diameter with a non-obstructive appearance. Due to a lack of means, our patient was subjected to oral medication, hygiene and dietary rules and rigorous monitoring. Conclusion: At the end of this study, the uroscanner is presented as the reference examination to better explore urinary pathologies. At the same time, it makes it possible to carry out a study of the organs surrounding the urinary tract. Always think about the association of several urinary pathologies each time you see a patient for renal colic.