Recurrent urinary tract infections in an adult with a duplicated renal collecting system

Abstract

Because of advancements in fetal imaging, anatomic variants of the genitourinary tract are most often discovered in the antenatal period. As such, general internists are less likely to encounter adult patients with previously undiagnosed anatomic abnormalities of the renal collecting system, such as duplicated kidneys. These abnormalities put patients at risk for urinary obstruction and recurrent infections of the urinary tract. We report the case of a 40-year-old diabetic patient with a previously undiagnosed duplex kidney who had recurrent episodes of diabetic ketoacidosis triggered by urinary tract infections. She was ultimately found to have abscess formation in the duplicated renal moiety. We reviewed the epidemiology, diagnosis, and management of duplex kidneys. We also reviewed the indications for renal imaging in adult patients with similar clinical presentations.

Giant hydronephrosis secondary to an ectopic ureter associated with bilateral duplex collecting system: a case report

“…A various range of symptoms might manifest according to the associated distortions and the case severity. The vast majority of cases are being diagnosed in early childhood [ 7 ]. However, a large number of patients are asymptomatic and diagnosed incidentally.…”

Bilateral complete duplication of ureter with ectopic ureter presenting as persistent urinary dribbling with normal voiding pattern in 17-year-old female: Case report

“…Recurrent UTI in pediatric patients may suggest duplication with the risk of UTI increased 20 times in pediatric age group. Iatrogenic ureteral injuries can be a serious complication in abdominal or pelvic operation; more commonly during gynecological and general surgical procedures due to duplication of the ureter [ 1 , 7 , 8 ]. In complete duplication, ureter usually from the upper moiety insert into the vagina, urethra, epididymal region or vestibule and presents with the problems of persistent urinary incontinence, continuous urinary dribbling and wetting and can cause ureteroceles [ 9 ].…”

“…Ureteric duplication is urinary tract anomalies with the incidence in between 0.5% and 3%. Union of two proximal branches of ureter occurs before inserting into the bladder in partial duplication while two ureters insert separately into the bladder in complete one with later being rarer type [ 1 ]. Duplication of ureter is more common in female than male with higher prevalence in Caucasian females [ 2 ].…”

A Spectrum of Entities That May Mimic Abdominopelvic Abscesses Requiring Image-guided Drainage

“…A duplicated collecting system is the most common type of normal variant renal anatomy, with a reported prevalence of 0.3%-6% (34,35). The upper pole moiety is predisposed to obstruction, while the lower pole moiety is predisposed to reflux.…”