Ealing Isaac, Calopedos Ross, Basto Marnique, Palma Catalina, Boulas John
Urology Department, Royal Prince Alfred Hospital, Sydney, New South Wales 2050, Australia.
Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales 2006, Australia.
J Surg Case Rep. 2022 Nov 26;2022(11):rjac547. doi: 10.1093/jscr/rjac547. eCollection 2022 Nov.
A bifid ureter is an atypical anatomical variation that occurs with an incidence of 1-10%. This anomaly is in a continuum of duplex collecting systems and most commonly involves a common distal ureter. This is usually asymptomatic and is predominantly an incidental diagnosis, nevertheless, is a potential risk factor for urolithiasis formation. Current surgical management of larger staghorn calculi favours percutaneous nephrolithotomy (PCNL) over traditional open surgery, however for multiple calculi and complex anatomy PCNL would require multiple punctures, with increased risk of bleeding, pleural injury, sepsis and ultimately failed stone clearance. We describe the case of a 71-year-old female with multiple calculi in bifid anatomy. A single open approach, aided with cold-ischaemia was successfully utilized in this context.
双肾盂输尿管是一种非典型的解剖变异，发生率为1%-10%。这种异常是重复集合系统连续变化的一种情况，最常见的是涉及一条共同的远端输尿管。它通常无症状，主要是偶然诊断出来的，不过，它是尿路结石形成的一个潜在危险因素。目前对于较大的鹿角形结石，手术治疗更倾向于经皮肾镜取石术（PCNL）而非传统开放手术，然而对于多发结石和复杂解剖结构，PCNL需要多次穿刺，会增加出血、胸膜损伤、脓毒症风险，最终导致结石清除失败。我们描述了一例71岁女性双肾盂输尿管解剖结构中有多发结石的病例。在此情况下，成功采用了一种单一的开放入路并辅助冷缺血技术。
