Duplicated collecting system

The normal urinary collecting system develops from a single ureteric bud arising the mesonephric (Wolffian) duct. migrates to meet primitive kidney (metanephros), where it into system. Abnormalities in signaling pathways are thought result variety of variants, including two buds duct (complete duplication) or one that bifurcates during development (incomplete duplication).1Uetani N. Bertozzi K. Chagnon M.J. Hendriks W. Tremblay M.L. Bouchard M. Maturation ureter-bladder connection mice is controlled by LAR family receptor protein tyrosine phosphatases.J Clin Invest. 2009; 119: 924-935PubMed Google Scholar incidence duplication adults be approximately 0.7% 4%, with incomplete more common than complete duplication.2Privett J.T. Jeans W.D. Roylance J. and importance renal duplication.Clin Radiol. 1976; 27: 521-530Abstract Full Text PDF PubMed Scopus (130) term duplicated (or duplex) defined as separate, noncommunicating pelves. In duplication, each pelvis has an associated ureter inserts independently bladder. pelves present but share (bifid) bladder at some point before reaching A measuring slightly larger (above 95th percentile for gestational age) seen longitudinally.3Abuhamad A.Z. Horton Jr., C.E. S.H. Evans A.T. Renal anomalies fetus: clues prenatal diagnosis.Ultrasound Obstet Gynecol. 1996; 7: 174-177Crossref (30) One lower pole second upper (Figure). Although bifid ureters present, both difficult visualize unless dilated. estimated bilateral 30% cases.3Abuhamad should inspected ureterocele, which appears cystic structure wall. Of note, if full, ureterocele may compressed therefore not seen. draining moiety typically ectopic insertion site located inferior medial site. If usually prone abnormalities moiety. abnormality hydronephrosis because obstructive process. appearance, although vesicoureteral reflux can occur.4Didier R.A. Chow J.S. Kwatra N.S. Retik A.B. Lebowitz R.L. tract: embryology, imaging appearances clinical considerations.Pediatr 2017; 47: 1526-1538Crossref (38) isolated finding only rarely aneuploidy genetic syndromes. detailed evaluation fetal anatomy indicated seen, additional uncommon. fetus normal-sized When initial finding, differential diagnoses include physiological transient other congenital tract. Assessment size number using longitudinal view recommended. findings normally sized rule out cause hydronephrosis. All causes hydronephrosis, ureteropelvic junction obstruction reflux, considered. An abnormally also urethral atresia, Prune-Belly syndrome, posterior valves. occasionally systems; therefore, helpful differentiating between duplex systems. Finally, enlarged lacks presence tumor. Overall, tumors rare, mesoblastic nephroma most commonly detected. This tumor arises exclusively third trimester pregnancy demonstrates rapid growth.5Cho J.Y. Lee Y.H. Fetal tumors: ultrasonographic characteristics.Ultrasonography. 2014; 33: 240-251Crossref (34) anomaly history unremarkable, chance syndrome low. component this suspected systems seem have autosomal dominant inheritance families.6Atwell J.D. Cook P.L. Howell C.J. Hyde I. Parker B.C. Familial double ureters.Arch Dis Child. 1974; 49: 825-826Crossref no further noted on ultrasound, beyond standard screening ultrasound examination recommended assess monitor amniotic fluid volume. Otherwise, obstetrical care delivery warranted. neither prenatally, considered variant, prognosis excellent. However, postnatal indicated. Obstruction, incontinence, infection occur, lead scarring dysplasia left untreated. relatively nature significantly chromosomal On necessary appreciate anomaly, kidney. detected antenatally followed up does follow-up