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Case Reports
. 2019 May 4;13(1):128.
doi: 10.1186/s13256-019-2058-z.

Bilateral duplex collecting system with bilateral vesicoureteral reflux: a case report

Diataga Sylvestre Yonli  1 , Marouene Chakroun  2 , Selim Zaghbib  2 , Delphine Ye  3 , Abderrazak Bouzouita  2 , Amine Derouiche  2 , Mohamed Riadh Ben Slama  2 , Haroun Ayed  2 , Mohamed Cherif  2 , Mohamed Chebil  2
Affiliations
Case Reports

Bilateral duplex collecting system with bilateral vesicoureteral reflux: a case report

Diataga Sylvestre Yonli et al. J Med Case Rep. .

Abstract

Background: 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.

Case presentation: 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.

Conclusions: 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.

Keywords: Bilateral; Duplex collecting system; Heminephrectomy; Vesicoureteric reflux.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable. Written consent was obtained from the patient to participate in this case report.

Consent for publication

Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Competing interests

The authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Voiding cystourethrography imaging showing bilateral reflux grade IV vesicoureteral reflux on the left (white arrow) and grade I vesicoureteral reflux on the right (black arrow)
Fig. 2
Fig. 2
Voiding cystourethrography imaging showing left grade IV VUR (arrow)
Fig. 3
Fig. 3
Coronal view of computed tomography scan with poor opacification of left upper pole moiety (arrow)
Fig. 4
Fig. 4
Excretory phase of computed tomography scan. a A 3/4 left view showing the upper pole moiety (white arrow) and the lower pole moiety (black arrow). b Bilateral duplex collecting system with hydroureteronephrosis of the left upper collecting system. The upper pole moieties and their ureters are poorly opacified (white arrows) especially on the right. The black arrows show the lower pole moiety ureters
Fig. 5
Fig. 5
Intraoperative picture during left heminephrectomy showing left duplicated collecting system with the upper pole ureter (white arrow) and the lower pole ureter (blue arrow)
Fig. 6
Fig. 6
Timeline of the case. CT computed tomography, VCUG voiding cystourethrography
See this image and copyright information in PMC

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