ISSN: 2251-8363    eISSN: 2251-8819  
J Nephropathol. 2018;7(2):98-100.
doi:10.15171/jnp.2018.23

Case Report

Appendix graft as a ureter substitution in recurrent ureter stenosis in horse -shoe kidney; a case report

Ali Taghizadeh Afshari 1, Rohollah Valizadeh 2, Saman Farshid 1 *

1 Nephrology and Kidney Transplant Research Center, Urmia University of Medical Sciences, Urmia, Iran
2 Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran and PhD student in Epidemiology, Department of Epidemiology, Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
*Corresponding author: Saman Farshid, Email: safarshid22@gmail.com

Abstract

Background: A horseshoe kidney is the most common renal fusion anomaly and occurs in 0.2% to 0.3% of the population. Horseshoe kidneys are fused by the formation of an isthmus between the lower poles of the left and right kidneys during development. The insertion of the ureter in the renal pelvis is displaced super-laterally, probably as the result of incomplete renal rotation, and is associated with a significant rate of ureteropelvic junction (UPJ) obstruction.

Case Presentation: We report a patient with single kidney at right side with obstruction in upper ureter. Before the surgery our plan was transureteroureterostomy according to failure of previous surgeries, dismembered pyeloplasty and ureterocalicostomy, but after mobilizing the proximal ureter we noticed that transureteroureterostomy was impossible because of short fibrotic ureter. Other choices such as Boari flap technique with psoas hitch is impossible because of small fibrotic bladder, so we decided to use appendix as ureter substitute.

Conclusions: According to our experience and previous studies, we can use appendix as a ureter substitution in refractory proximal and middle ureter stenosis, but in our case we anatomized proximal ureter to appendix instead of anastomosis of pelvic to appendix.

Implication for health policy/practice/research/medical education:

Given the acceptable results of appendix as a ureter substitution in refractory proximal and middle ureter stenosis, it can be used instead of anastomosis of pelvic in such a situation.

Please cite this paper as: Taghizadeh Afshari A, Valizadeh R, Farshid S. Appendix graft as a ureter substitution in recurrent ureter stenosis in horse -shoe kidney; a case report. J Nephropathol. 2018;7(2):98-100. DOI: 10.15171/jnp.2018.23.

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Submitted: 08 Jul 2017

Accepted: 13 Sep 2017
First published online: 27 Sep 2017
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