Christopher P. Coppola, Alfred P. Kennedy, Jr. and Ronald J. Scorpio (eds.)Pediatric Surgery2014Diagnosis and Treatment10.1007/978-3-319-04340-1_42
© Springer International Publishing Switzerland 2014
Renal Duplication Anomalies
(1)
Department of Pediatric Urology, Janet Weis Children’s Hospital, 100 N. Academy Av. MC 13-16, Danville, PA 17822, USA
Abstract
Renal duplication anomalies are common in the pediatric population, but are frequently clinically silent. They will come to the attention of a medical provider if they develop symptoms of infection or obstruction.
Renal duplication anomalies are common in the pediatric population, but are frequently clinically silent. They will come to the attention of a medical provider if they develop symptoms of infection or obstruction.
1.
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Pathophysiology:
(a)
Epidemiology:
(i)
Very common.
(ii)
Estimate 1/50 population has a duplicate collecting system.
(iii)
Only come to medical attention if there is associated pathology.
(b)
Definition:
(i)
Renal duplication:
1.
Complete: two separate openings for drainage into bladder.
2.
Incomplete: join together with one ureter entering bladder.
(ii)
Ureterocele:
1.
Cystic dilation of distal ureter.
2.
Can be associated with a single system: described as orthotopic.
3.
Duplex system:
(i)
Ectopic.
(ii)
If extend down urethra submucosally known as cecoureterocele.
(iii)
Ureteral ectopia.
1.
Lateral ectopia within bladder results in a short submucosal tunnel of the ureter and usually vesico-ureteral reflux (VUR).
2.
Caudal ectopia results in ureteral atresia and obstruction.
3.
Possible exit outside bladder and incontinence in girls.
(c)
Weigert-Meyer law:
(i)
Governs the relationship of duplication and ectopia.
(ii)
The ureter from lower pole moiety kidney always is lateral ectopic and refluxes.
1.
Can also have concomitant ureteropelvic junction obstruction (UPJO).
(iii)
The upper pole ureter terminates caudal and medial and is obstructive.
