Obstructed right upper moiety in a bilateral partial duplex renal system in an adult: a case report

Solomon Kenechukwu Anyimba,1 Ikenna Ifeanyi Nnabugwu,1 Chinwe Andrea Nnabugwu2

1. Department of Surgery, College of Medicine, University of Nigeria Ituku-Ozalla,  Enugu, Nigeria
2. Department of Health Administration and Management, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria

Correspondence to: Dr. Ikenna Ifeanyi Nnabugwu; email: ikenna.nnabugwu@unn.edu.ng

Received: 8 April 2020; Revised: 24 June 2020; Accepted: 25 June 2020; Available online: 7 July 2020

Summary

Duplex renal system, a common congenital anomaly of the kidney and urinary tract, is preferably identified through screening. For obstructed symptomatic duplications, prompt relief of obstruction to forestall renal parenchymal loss is recommended. We present a case of neglected obstruction of the right upper moiety in an adult female with discordant bilateral renal duplex system. A 49-year-old female with a 10-year history of recurrent right flank pain and fever presented for clinical evaluation and treatment. She had no such symptoms in early childhood. A diagnosis was made of obstructed right upper renal moiety in bilateral discordant renal duplication with complete moiety parenchymal destruction. She had right renal exploration with complete excision of the hydronephrotic sac and the grossly dilated moiety ureter down to the obstruction at the fusion of both upper and lower moiety ureters. Her postoperative period was uneventful. She is symptom-free and her urinary tract is structurally intact. Hitherto asymptomatic renal duplication can become symptomatic in early adulthood from intrinsic moiety ureter obstruction, suggesting a need for lifetime monitoring of persons with duplex renal systems. Late presentation with neglected symptoms, and consequent renal moiety destruction as seen here, is a result of the absence of such monitoring

Keywords: Duplex renal system, Obstruction
Ann Afr Surg. 2021; 18(2): 119–122
DOI: http://dx.doi.org/10.4314/aas.v18i2.11
Conflicts of Interest: None
Funding: None
© 2021 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.

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