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Case of the Week 311 
What's the most likely diagnosis?
- 51 year old with abdominal pain
- Renal papillary necrosis
- Carcinoma of the bladder
- Fractured ribs
- Cystocele
- Ureterocele
Additional Image- Axial CT image of the pelvis
Additional Image
Axial CT image of the pelvis at level of bladder
Answer:
5. Ureterocele
More (Click Discussion Tab)
Ureterocele
General Considerations
- Congenital saccular outpouching of distal ureter into the urinary bladder
- Most common in white females
- Most are left-sided but about 10% are bilateral
- Most ureteroceles found in adults are orthotopic whereas those in children are far more commonly ectopic
- In a duplex system, 80% of ureteroceles are associated with the upper pole moiety
- Upper pole frequently obstructs
- Lower pole undergoes vesico-ureteral reflux
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