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Fever and left flank pain
A 24 y old male patient was admitted for the 3rd time in ER due to left flank pain and fever and chills.
Sonography revealed left side hydronephrosis with out hydroureter.
Patient underwent renal scintigraphy with showed decreased function in left lower pole and a normal function in left upper pole.
An IVU was requested which showed hydronephrotic left lower pole and normal left upper pole calyxes . VCUG was normal . single left ureter rising from left upper pole was visible in IVU.
At cystoscopy there was normal looking single left ureteral orifice. Left kidney was explored through left flank incision and full duplication of left renal pelvis and incomplete ureteral duplication with juncture in mid ureter was encountered of which the lower pole pelvi-ureteral junction was obstructive. Patient underwent dismembered pyeloplasty .
   
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