R. Mund (Leipzig)  

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18 Months  

Male  

Pelvis-Ureter  

unknown  

Incidental findings in a 1.5 year-old boy with melena, no fever. Urine analysis was without findings (Transferral to abdominal sonography to rule out an invagination).  

A ureterocele is described as a cystic widening of the distal, submucosal running, intravesical segment of the ureter.
One differentiates the ureteroceles according to the location of the afflicted ureterostium in intravesical (orthotopic) or extravesical (ectopic = in the bladder's neck or in the urethra).  

<- view Ultrasound 1

Ultrasound 1: urinary bladder with representation of the urine flow out of the ureters. Somewhat cystic-looking ostia (right > left) in an orthotopic situation in the trigonal area of the bladder.




<- view Ultrasound 2

Ultrasound 2: urinary bladder shown longitudinally with ureterocele on the right.




<- view Ultrasound 3

Ultrasound 3: Color doppler of the urinary bladder with proof of the flow of urine out of the right ostial mouth when ballooning the cele.




<- view Ultrasound 4

Ultrasound 4: representation like the left ostium, only with slighter findings



 

Imaging including endoscopy  

N/A  

Frequency: 0.2-0.3 in 1000 children. Ectopic ureteroceles are frequently associated with double kidneys (in that case, the cele is located in the upper region in 80%) and associated with vesicoureteral reflux. Orthotopic celes, on the other hand, can be normally found (90%)in just one kidney.

Symptoms appear in ectopic celes usually in the 1st year, in orthotopic in much less common and are frequently found later: urinary tract infections, concrement formation, urosepsis, urine obstruction with reduced function of the kidney.
A protruding ureterocele into the urethral lumen is the most frequent cause of an acute urine retention in newborns.  

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Ureterocele, orthotopic, orthotopic ureterocele, orthotope, ectope, cystic widening of the ureter, incidental finding, melena, child, childhood, pediatric radiology  

R Mund. Ureterocele, orthotopic. PedRad [serial online] vol 2, no. 8.
URL: www.PedRad.info/?search=20020823142413