Üreter Ünilateral Parsiyel Duplikasyonu - Konjenital Anomali

Böbrek ve drenaj sisteminin embryogenezisi konjenital anomalinin gelişmi ve sıklığından sorumludur. Renal damarların yapısını incelemek için Madras Medical College, Chennai anatomi bölümünden 50 çift yetişkin insan böbreği elde ettik. Elli çift üzerinden; bir sağ böbrek örneğinde üreter duplikasyonu gözlemledik fakat aynı çiftin sol böbreği normaldir. Üreterin unilateral duplikasyonu renal pelvisten, daha sonra tek bir üreter olarak devam eden ve mesaneye katılan duplike üreterin her iki pelvik ağızın yakınındaki pelvik ağıza kadar genişler. Üreterin kısmi duplikasyonunun insidansı 100 böbrek üzerinden 1'dir. Aynı zamanda anteriyor yerine posteriyor olarak giden duplike üreteri kesen, aorttan inferior anormal arter olarak oluşan, inferior segmental arteri de gözlemledik. Çalışmamız ameliyatı planlamadan önce duplike üreter ile ilişkili vasküler varyasyonlar hakkında klinisyenlere önden bilgi vermektedir

Unilateral Partial Duplication of Ureter–Congenital Anomaly

Purpose: The embryogenesis of the kidney and drainage system accounts for the development and frequency of congenital abnormalities. Material and Methods: We collected 50 pairs of adult human kidneys to study the renal angioarchitecture from department of anatomy Madras Medical College, Chennai. Results: Out of 50 pairs in one specimen of right kidney we observed duplication of ureter but the left kidney of same pair is normal. The unilateral duplication of ureter extend s from renal pelvis to pelvic brim near the pelvic brim both the duplicated ureter joined later continue as single ureter and entering the urinary bladder. The incidence of partial duplication of ureter is 1% out of 100 kidneys. We also observed inferior segmental artery arising from the aorta as inferior aberrant artery which crosses the duplicated ureter posteriorly instead of going anteriorly. Conclusion: Our study gives primary knowledge to the clinicians about the vascular variations associated with duplication ureter before planning a surgery.

___

  • Larsen JW. Development of the Urogenital system. In: Larsen JW. Essentials of Human Embryology. Churchill Livingstone Inc.1998;176-81.
  • Moore KL, Persaud TVN. The Developing Human. 8th Ed., Noida, India, Thomson Press (I) Ltd., Saunders Elsevier. 2009;255.
  • Sadler, T. W. Langman's medical embryology - 11th ed. ISBN 978-0-7817-9069-7. 2010;240.
  • Siomou E. Duplex collecting system diagnosed during the first 6 years of life after a first urinary tract infection: a study of 63 children, Journal of Urology. 2006;175;2:678-81.
  • Limura A, Yi SQ, Terayama H, Naito M, Buhe S, Oguchi T, Takahashi T, Miyaki T, Itoh M. Complete ureteral duplication associated with megaureter and ureteropelvic junction dilatation: report on an adult cadaver case with a brief review of the literature. Ann Anat. 2006;188:371–5.
  • Konstantinos Velaoras. Renal duplication. Essentials in Pediatric Urology. ISBN: 978-81-308-0511-5. 2012;89-94.
  • Rickwood MkA, Maddan PN,Boddy MS-A. Duplication anomalies,ureteroceles and ectopic ureteres. In:Thomas FmD, Duffy GP, Rickwood MkA(eds). Essential of Paediatric Urology. 2nd Edition. Informa Healthcare. 2008;93-108.
  • Verna C, Mosso L, Moncelli G, Monaco A. Renal angiolipoma associated with bilateral double ureter. A clinical case. Minerva Urol Nefrol. 1997;49:39–44. (Italian).
  • Nation EF. Duplication of the kidney and ureter: a statistical study of 230 new cases. J Urol. 1944;51:456–65.
  • Campbell JE. Ureteral peristalsis in duplex renal collecting systems. Am J Roentgenol Radium Ther Nucl Med. 1967;99:577–84.
  • Genyk Y, Knight R, de Csepel J, Burrows L. Successful transplantation of pediatric en bloc kidneys with bilateral double ureters. Transpl Int. 1999;12:281–2.
  • Androulakakis Ph. Renal and Ureter Anomalies. In: Androulakakis Ph (eds).Paediatric Urology. Greek Edition. Beta. 1993;204-20.
  • Nepple GK, Cooper SCh, Howard M. Snyder MH. Ureteral Duplication, Ectopy and Ureteroceles. In: Paediatric Urology, 2nd Edition. Saunders Elsevier. 2010;339-52.
  • MacConaill MA. A case of bilateral double ureter. Br J Urol.1929;1:302–4. 15. Whonamedi– Weigert-Meyer rule.
  • http:/www.whonamedit.com/synd.cfm/2837.html
  • (accessed on September 20th, 2010)
  • Pujari Dinanath, Amalladinna Ashwini, Gubbi Annarao, Santojirao Nagaraj. Bilateral complete duplex renal pelves and ureters-a case report. International Journal of Anatomical Variations. 2011;4:192–4.
Cukurova Medical Journal-Cover
  • ISSN: 2602-3032
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1976
  • Yayıncı: Çukurova Üniversitesi Tıp Fakültesi