[Bifid ureter with a blind branch as cause of unspecified abdominal pain. Report of a new case and review of the literature].

OBJECTIVE

To report a case of bifid left ureter with a blind-ending branch in a 35 year-old female patient who complained of poorly defined abdominal pain.

METHODS

Clinical features, radiologic findings, differential diagnosis and therapeutic approach are discussed and the literature reviewed.

RESULTS

Bifid ureter with a blind branch is not an uncommon anomaly as generally believed. There are at least a hundred and seventy-five cases reported in the literature reviewed.

CONCLUSIONS

Diagnosis is most commonly made by intravenous urography (IVU) with oblique views showing the blind-ending segment filled by retrograde uretero-ureteral reflux. However blind segment does not always fill on excretory urography and retrograde pyelography is required for diagnosis (an ectopic kidney at the distal end of the blind-ending branch should be easily seen on CT scan or ultrasonography). A voiding cystourethrography (VCUG) may be needed to demonstrate an ureteral branch with coexistent vesicoureteral reflux. Treatment is initially conservative although complications or severe symptoms require surgical excision of the blind branch together with antireflux reimplantation of the normal ureter when vesicoureteral reflux is present.