Adenipekun Ayokunle, Gaballa Nader, Darrad Maitrey
Urology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, GBR.
Urology, University Hospitals Birmingham NHS Foundation Trust, Birmimgham, GBR.
Cureus. 2023 Jul 7;15(7):e41489. doi: 10.7759/cureus.41489. eCollection 2023 Jul.
Ureteric calculi are common urological problems. However, the management of stone disease varies considerably with patient choice and anatomy. There are few reports about ureteral calculi in patients with unilateral complete duplex kidneys managed by ureteroscopy. We hope to increase the awareness of urologists when investigating patients with similar symptoms. We present the case of a 28-year-old man with recurring left flank pain. Non-contrast computed tomography (CT) scans of the kidney showed an impacted left vesicoureteric junction stone measuring 6 mm. Intra-operatively, a stone in the left duplex system was discovered. He was managed with ureteroscopy, laser fragmentation, and the insertion of ureteric stents. The case demonstrates the complexity of managing ureteric stones in a complete duplex kidney. We highlighted the diagnostic limitations of non-contrast scans in identifying duplex systems. It is important to consider contrast CT scans in patients with unusually persistent symptoms to outline the anatomy of the kidney and collecting systems.
输尿管结石是常见的泌尿系统问题。然而，结石疾病的治疗方法因患者的选择和解剖结构而有很大差异。关于经输尿管镜治疗单侧完全重复肾患者输尿管结石的报道很少。我们希望提高泌尿外科医生在诊治有类似症状患者时的认识。我们报告一例28岁复发性左侧腰痛男性患者。肾脏的非增强计算机断层扫描（CT）显示左侧膀胱输尿管连接部有一枚6毫米的嵌顿结石。术中发现左侧重复系统有结石。对其进行了输尿管镜检查、激光碎石及输尿管支架置入术。该病例显示了完全重复肾中输尿管结石治疗的复杂性。我们强调了非增强扫描在识别重复系统方面的诊断局限性。对于症状异常持续的患者，考虑进行增强CT扫描以勾勒肾脏和集合系统的解剖结构很重要。
