Pelviureteric junction obstruction in duplex system.

Area of Science:

• Urology
• Pediatric Nephrology

Background:

• Duplex kidney systems can present with congenital anomalies.
• Ureteropelvic junction (PUJ) obstruction is a common cause of pediatric kidney disease.
• PUJ obstruction in duplex systems typically affects the lower moiety ureter.

Observation:

• This report details an unusual case of PUJ obstruction in the upper moiety of a duplex kidney.
• The obstruction involved a long, stenotic ureter segment.
• This segment drained a functionally insignificant and infected portion of the kidney.

Findings:

• The obstruction was intrinsic, characterized by ureteral stenosis, not extrinsic compression.
• The affected upper moiety was infected and functionally compromised.
• The contralateral kidney was hypoplastic and non-functional.

Implications:

• This case highlights the variability of PUJ obstruction presentation in duplex kidneys.
• Surgical intervention, such as upper polar nephrectomy, may be necessary for such anomalies.
• Early diagnosis and management are crucial for preserving renal function.