[Infected upper renal pole in a duplex system with paravaginal abscess]

Area of Science:

• Urology
• Medical Imaging
• Congenital Anomalies

Background:

• Diagnosis of functional duplex systems can be challenging due to atypical presentations.
• Congenital anomalies of the urinary tract may present with misleading symptoms, delaying appropriate medical intervention.

Observation:

• A 40-year-old female presented with fever and flank/abdominal pain, initially suspected as a paravaginal abscess.
• Imaging revealed a renal abscess and suggested an ectopic ureter, leading to further investigation.
• The patient exhibited symptoms of a right-sided renal abscess and a paravaginal abscess.

Findings:

• Sonography and CT-scan identified a renal abscess and a suspected ectopic ureter.
• Antegrade pyelography and IVP confirmed a right ectopic, blind-ending duplex ureter with upper pole hydronephrosis.
• Surgical intervention included upper pole resection and ureterectomy.

Implications:

• Congenital urinary tract anomalies should be considered in cases of unexplained abscesses, particularly in the genitourinary region.
• Early recognition of atypical symptoms associated with duplex systems is crucial for timely diagnosis and treatment.
• This case underscores the importance of comprehensive diagnostic workups for complex presentations involving abscesses.