|What Happens in the Formation of Ureteral Duplication? A Case Report and Brief Literature Review|
|Fatemeh Mortazavi1, Ramin Salimnejad2, Reza Asghari3, Maryam Eyvazi3, Farhad Mortazavi1, Simin Menshari1, Hamed Shoorei3,4, Maliheh Ahin5|
|1Imaging Center, Ardabil Alavi Hospital, Ardabil University of Medical Sciences, Ardabil, Iran
2Research Laboratory for Embryology and Stem Cells, Department of Anatomical Sciences and Pathology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
3Department of Anatomical Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
4Department of Anatomical Sciences, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
5Taleghani Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
CJMB 2019; 6: 414-417
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Keywords : Ureteral Duplication, Congenital Anomalies, Computed Tomography Scan, KUB Radiography, Embryology
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Radiologists frequently diagnose two ureteral duplications including complete and incomplete types. Incomplete ureter duplication, which is also called bifid ureter, refers to a situation in which the ureteric bud bifurcates before meeting the metanephric blastema. On the other hand, complete ureter duplication, which is also named double ureter, defines another situation in which two separate ureteric buds, on either side of the embryonic body, are formed from the mesonephric duct (Wolffian duct) and then arrive in the metanephric blastema. Therefore, two separate ureters, renal pelvis, as well as a duplex kidney (upper and lower poles) are formed in a common renal capsula. Embryologically, in complete ureter duplication, the ureteric buds rotate 108 degrees when incorporating into the urogenital sinus, which is known as Weigert-Meyer rule. In this posture, the upper and lower poles of the kidney are drained by the laterocranial and mediocaudal orifice, respectively. Complete duplication is more common in women than men and is often associated with vesicoureteral reflux, ectopic ureterocele, and/or ectopic ureteral insertion. In the present case report, a 40-year-old woman, mainly complaining of abdominal and lower back pain, was discovered to have bilateral complete ureteral duplication on computed tomography (CT) scan, as well as kidney, ureter, and bladder x-ray radiography. Moreover, the embryological causes were discussed in forming the duplicated ureter and duplex collecting system.
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