Inoue H, Okada S, Suzuki T, Takasaki N, Miyazaki S, Kaneda K
Department of Urology, Osaka Medical School.
Hinyokika Kiyo. 1991 May;37(5):523-5.
Blind ending bifid ureter is a rare anomaly in the urinary tract. This anomaly may result from failure of a premature branch of the ureteral bud to join with the metanephric blastema. A 21-year-old man was admitted with macroscopic hematuria and colic pain in the left flank region. Urinalysis demonstrated hematopyuria and excretory urography suggested bifid ending accessory ureter with a stone on the left side. Surgical exploration showed that the accessory ureter was bifurcated from the left ureter at about 5 mm from the bladder wall and ran parallel with the left ureter. Although dense adhesions to the surrounding tissue existed, the accessory ureter was resected at the site of the junction. It measured 3 cm in length and 1 cm in greatest diameter. The stone found at the tip of the accessory ureter was composed of calcium oxalate (24%) and calcium phosphate (76%). Histological examination revealed that the ureter had all layers of normal ureteral structure and no renal tissue was identified in the specimen resected. During a follow-up period of 22 months after the operation, he was free of urinary tract infection and abdominal pain. Of 77 cases with blind ending bifid ureter reported in the Japanese literature, a ureteral stone was found in the blind branch in only 5 cases.
盲端双叉输尿管是一种罕见的泌尿道异常。这种异常可能是由于输尿管芽的一个过早分支未能与后肾胚基融合所致。一名21岁男性因肉眼血尿和左侧胁腹绞痛入院。尿液分析显示血尿,排泄性尿路造影提示左侧有盲端双叉副输尿管并伴有结石。手术探查发现副输尿管在距膀胱壁约5毫米处从左输尿管分出,并与左输尿管并行。尽管与周围组织存在致密粘连,但在连接处将副输尿管切除。其长度为3厘米,最大直径为1厘米。在副输尿管末端发现的结石由草酸钙(24%)和磷酸钙(76%)组成。组织学检查显示输尿管具有正常输尿管结构的各层,在切除的标本中未发现肾组织。术后22个月的随访期间,他未发生尿路感染和腹痛。在日本文献报道的77例盲端双叉输尿管病例中,仅5例在盲支中发现输尿管结石。