Primary obstructive megaureter with ureteric calculi in a child

Abstract

Congenital megaureter is an important differential diagnosis among the known causes of hydroureteronephrosis in children. Obstructive megaureter is usually due to a narrowed and aperistaltic prevesical portion of the ureter. The congenital megaureter is usually asymptomatic in children. Association of an obstructive megaureter with ureteric calculi, however, is a rare phenomenon in the pediatric age group. Calculi if present are usually secondary to stasis and asymptomatic, presenting usually at adulthood or adolescence. A differential diagnosis of obstructive megaureter should be kept in mind in a child who presents with symptoms such as hematuria, pain, and obstructive nephropathy, especially when there are an associated calculi in the ureter. We present a case of a 4-year-old child whose chief complaint was hematuria and on further investigation was found to have unilateral obstructive megaureter with secondary ureteric calculi on an intravenous urogram.

Keywords

• Obstructive megaureter
• pediatric
• ureteric calculi