Abstract
Duplication of the collecting system is the most common congenital abnormality of the upper urinary tract (0.8-2%), with unilateral duplication more common than bilateral [1-4]. In complete duplication, ureters typically follow the Weigert-Meyer rule of the upper pole inserting caudomedial (may be obstructed) and the lower pole inserting craniolateral (may reflux) in the bladder. Very rarely is there deviation from this pattern. Few cases of uncrossed double ureters with lower pole dysplasia, ureterocele, or ectopia have been reported [5-8]. We report a breach in the law with a case of an asymptomatic 1-month old new-born male with lower pole ureteral ectopia and obstruction. We discuss the importance of thorough work up with emphasis on differential diagnoses and care team-based decisions in the evaluation of paediatric hydronephrosis.
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