|What Happens in The Formation of Ureteral Duplication? A Case Report and Brief Literature of Review|
|Fatemeh Mortazavi1, Ramin Salimnejad2, Reza Asghari3, Maryam Eyvazi3, Farhad Mortazavi1, Simin Menshari1, Hamed Shoorei3|
|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
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Keywords : Ureteral Duplication, Congenital Anomalies, Computed Tomography Scan, KUB radiography, Embryology
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There are two types of ureteral duplication, complete and incomplete, that frequently diagnosed by radiologists. 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 called double ureter, refers to another situation in which two separate ureteric buds on either side of the embryonic body are formed from the mesonephric duct (Wolffian duct), then arrive in the metanephric blastema. Therefore, two separate ureters, renal pelvis, as well as a duplex kidney (upper and lower pole) in a common renal capsula are formed. Embryologically, in complete ureter duplication, the ureteric buds when incorporating into the urogenital sinus, rotate 108 degrees, which is known as Weigert-Meyer rule. In this posture, the kidney"s upper and lower poles are drained by the laterocranial and the mediocaudal orifice, respectively. Complete duplication is more common in women than in men and is often associated with vesicoureteral reflux, ectopic ureterocele, and/or ectopic ureteral insertion. In this present case report, a 40-year-old woman with the main complaint of abdominal and lower back pain was discovered on CT scan and KUB radiography to have bilateral complete ureteral duplication (Fig. 1). Moreover, the embryological causes in forming the duplicated ureter and duplex collecting system have been discussed.
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