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    Case of the Day
    Ureterocele, orthotopic

    Modality: Ultrasound Modality: Ultrasound Modality: Ultrasound Modality: Ultrasound

    View here all images of this case in different sizes !



    Go to the top of the page ID: 20020823142413
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     Ureterocele, orthotopic   
     Available images: There are Ultrasound images available for this case. [ Ultrasound ]   
     Author/s:

    R. Mund (Leipzig)  

     
     Email Address:

    Viewable for logged on visitors (Log on)  

     
     Age:

    18 Months  

     
     Gender:

    Male  

     
     History:

    Incidental findings in a 1.5 year-old boy with melena, no fever. Urine analysis was without findings (Transferral to abdominal sonography to rule out an invagination).  

     
     Pathomorphology or Pathophysiology of this disease :

    A ureterocele is described as a cystic widening of the distal, submucosal running, intravesical segment of the ureter.
    One differentiates the ureteroceles according to the location of the afflicted ureterostium in intravesical (orthotopic) or extravesical (ectopic = in the bladder's neck or in the urethra).  

     
     Radiological findings:


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: urinary bladder with representation of the urine flow out of the ureters. Somewhat cystic-looking ostia (right > left) in an orthotopic situation in the trigonal area of the bladder.


    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: urinary bladder shown longitudinally with ureterocele on the right.


    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Color doppler of the urinary bladder with proof of the flow of urine out of the right ostial mouth when ballooning the cele.


    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: representation like the left ostium, only with slighter findings

     

     
     Diagnosis confirmation:

    Imaging including endoscopy  

     
     Which DD would be also possible with the radiological findings:

    N/A  

     
     Course / Prognosis / Frequency / Other :

    Frequency: 0.2-0.3 in 1000 children. Ectopic ureteroceles are frequently associated with double kidneys (in that case, the cele is located in the upper region in 80%) and associated with vesicoureteral reflux. Orthotopic celes, on the other hand, can be normally found (90%)in just one kidney.

    Symptoms appear in ectopic celes usually in the 1st year, in orthotopic in much less common and are frequently found later: urinary tract infections, concrement formation, urosepsis, urine obstruction with reduced function of the kidney.
    A protruding ureterocele into the urethral lumen is the most frequent cause of an acute urine retention in newborns.  

     
     Comments of the author about the case:

    N/A  

     
     First description / History:

    N/A  

     
     Literature:

    N/A  

     
     Region-Organ:

    Pelvis-Ureter  

     
     Most likely etiology:

    unknown  

     
     Available images: There are Ultrasound images available for this case. [ Ultrasound ]   
    More cases from these authors: Search R. Mund in Medline R. Mund (16)     




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