RESUMEN
Spermatocele is a common cause of benign scrotal swelling that mostly arises from the head of the epididymis. It is a fluid-filled swelling containing spermatozoa. Torsion of a spermatocele is a very rare encounter for a urologist. It is poorly described in the English literature and there are only seven cases reported so far. There is no specific clinical feature suggesting spermatocele torsion and the diagnosis is often made during an emergency scrotal exploration. We report the eighth case of torsed spermatocele in a young adult diagnosed during emergency scrotal exploration for a suspected testicular torsion.
RESUMEN
Ureteral duplication is a common embryologic abnormality of the kidney with an incidence rate of 0.8% in adults. However, complete duplex ureters opening independently into the urinary bladder are rarely present. We report a 35-year-old female who presented with left flank pain in the last three years. Abdominal CT scan showed left complete duplicated system with lower moiety hydroureteronephrosis and obstructed midureteral stone. The patient underwent left retroperitoneal exploration with complete excision of the hydronephrotic sac. The postoperative course was uneventful without complications. In conclusion, a complete duplex kidney with lower moiety hydronephrosis caused by mid ureteric stone is rare. The renal duplication system should be diagnosed and followed with image guidance periodically as the late diagnosis may have poor outcomes with loss of the kidney or part of it.
RESUMEN
INTRODUCTION: A supernumerary kidney is an extremely rare congenital anomaly, defined as the presence of one or more extra kidneys. Thus far, there have been less than 100 cases reported in the medical literature. It has its capsule, vascular supply, and collecting system. It frequently causes diagnostic challenges in clinical practice. The supernumerary kidney can be symptomatic due to the presence of stone. CASE PRESENTATION: We present a case of a 19-year-old male patient who came to our clinic with the complaint of abdominal pain. On computed tomography urography (CTU), he was found to have a caudally located left fused supernumerary kidney with a separate vascular supply. Both left kidneys had a separately draining calyceal systems uniting at the left renal pelvis and drained by a single ureter. Multiple left renal stones (largest measures 4cm x 2.2cm) in both kidneys were also seen. The stones were removed surgically by doing pyelolithotomy and radial nephrolithotomy. The patient was doing well during follow-up visits with the improvement of abdominal pain. CONCLUSION: Supernumerary kidney is a very rare congenital renal anomaly. This case is even unique, because of the fused supernumerary kidney and the presence of a single left renal pelvis and ureter. Imaging is very essential for planning surgical intervention. Stones in such kidneys can be managed with nephrolithotomy and/or pyelolithotomy.