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논문분류	춘계학술대회 초록집
제목	A Rare Clinical Case Study of Calculus Induced Hydroureteronephrosis Obstructive Syndrome in a Patient with Two Separate Pelvicalcyeal System in Right Side with Bifid Ureter
저자	Anil Gautam, Bijay Subedi, Janak Awasthi
출판정보	2019; 2019(1):
키워드	Bifid Ureter \| Hydroureteronephrosis \| Calculus
초록	"IntroductionRenal abnormalities account for high percentage of congenital anomalies due to genetic disorder during gestation. A bifid or duples ureter is a rare case of congenital kidney anomalies resulting untimely and early division of ureteric diverticulum occurring in 0.88% population. Hydroureteronepjrosis is the dilatation of the kidney and ureter due to partial or complete blockage of ureter due to calculus. Here, we reported a rare clinical entity of hydroureteronephrosis caused by obstruction of calculus in a patient with bifid ureter . Case PresentationA male patient of age 38 presented with wide spectrum of manifestations such as pain in right abdomen, renal colic, flank pain, episodes of watery vomiting and non-bilious fever was studied. Blood pressure of 160/130 mmHg with acute hypertension was observed. Methods and MaterialsThis present case was diagnosed by the routine radiological procedures i.e. Computed Tomography Intravenous Pyleogram(CT IVP) via intravenous infusion of contrast medium followed by X-ray at specific interval of time correlating with lab findings. Finding, Discussion and ManagementThe single large calculus measuring approx. 8.6*9 mm right at the junction of bifid ureter was found which was subjected to extra corporeal shock wave lithotripsy resulting in fragmentation. A temporary stent was placed on the right side as a support. The biochemical assay of renal function test shows no any alternation. However, plenty of Red Blood Cells with Haematuria were found in urine analysis. Literature review suggest no any previous this type of case in Nepalese population. So, this can be said one of the rare clinical case study. Conclusion:The duplexing of renal system i.e. bifid ureter is of both medical and academic importance. Immediate life savings clinical interventions should be given in cases nephrolithiasis for preventing further damage and failure of renal system."
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