Obstruction of bifid ureter by two calculi: A case report

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The duplex ureter is a common anomaly of urinary tract, but preoperative sonography, plain abdominal radiography, or nonenhanced computed tomography (CT) often overlooked it when involved with urinary tract obstruction. In this report, We present a rare case of left Y-shaped bifid ureter and both ureter of upper moiety and common stem were obstructed respectively by 2 calculi.

Patient concerns:

A 47-year-old woman was admitted due to 3-day history of left-sided loin pain and low-grade fever. The patient was diagnosed with right renal atrophy and 2 calculi of left ureter associated with severe left hydronephroureterosis, and underwent left percutaneous nephrostomy and left ureterolithotomy without identification of the upper calculus in left ureter in another hospital.


After transfer of the patient to our hospital, preoperative contrast-enhanced CT detected the left Y shaped bifid ureter and the calculus in upper moiety ureter.


The migrated calculus was extracted by left ureterolithotomy.


The patient discharged uneventfully.


Contrast-enhanced CT should be recommended prior to any surgical procedures involved with upper urinary tract to exclude duplex ureter.

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