Yonli Diataga Sylvestre, Chakroun Marouene, Zaghbib Selim, Ye Delphine, Bouzouita Abderrazak, Derouiche Amine, Slama Mohamed Riadh Ben, Ayed Haroun, Cherif Mohamed, Chebil Mohamed
Department of Urology, Yalgado Ouedraogo University Hospital of Ouagadougou, Ouagadougou 03, 03 BP 7022, Burkina Faso.
Department of Urology, Charles Nicolle University Hospital of Tunis, Boulevard du 9 Avril 1938, 1006, Tunis, Tunisia.
J Med Case Rep. 2019 May 4;13(1):128. doi: 10.1186/s13256-019-2058-z.
A bilateral duplex collecting system is an unusual renal tract abnormality. Vesicoureteral reflux may be associated. We describe a rare case of bilateral duplex collecting system with bilateral vesicoureteral reflux in which the refluxing ureter on the left side drains the upper pole moiety contrary to what is often found.
A 24-year-old married Arab woman presented with ascending left-sided flank pain during micturition. She complained of recurrent urinary tract infections. A physical examination and laboratory tests were normal. Voiding cystourethrography and computed tomography scan detected bilateral duplex collecting system, grade IV vesicoureteral reflux on the left side, and grade I vesicoureteral reflux on the right. She underwent left heminephrectomy and dextranomer/hyaluronic acid injections on the right side. After a year of follow-up, a clinical examination and imaging findings were unremarkable.
A bilateral duplex collecting system with refluxing upper pole moiety ureter is a very rare entity. The diagnosis should be suspected when exploring any flank pain with recurrent urinary tract infections to avoid subsequent renal impairment. Furthermore, this case shows how some common symptoms may lead to finding an unexpected urinary tract abnormality.
双侧重复集合系统是一种罕见的泌尿道异常。可能伴有膀胱输尿管反流。我们描述了一例罕见的双侧重复集合系统合并双侧膀胱输尿管反流的病例，其中左侧反流的输尿管引流上极部分，这与通常所见情况相反。
一名24岁已婚阿拉伯女性在排尿时出现左侧胁腹疼痛。她主诉反复发生尿路感染。体格检查和实验室检查均正常。排尿性膀胱尿道造影和计算机断层扫描检测到双侧重复集合系统，左侧为IV级膀胱输尿管反流，右侧为I级膀胱输尿管反流。她接受了左侧半肾切除术和右侧注射葡聚糖/透明质酸。经过一年的随访，临床检查和影像学检查结果均无异常。
双侧重复集合系统伴上极部分输尿管反流是一种非常罕见的情况。在探究任何伴有反复尿路感染的胁腹疼痛时，应怀疑该诊断，以避免随后的肾功能损害。此外，该病例显示了一些常见症状如何可能导致发现意想不到的泌尿道异常。
