Harry R. Newman

Adult multicystic renal disease

Multicystic renal disease is a congenital lesion first described in 1936 (Schwartz) following removal of a kidney from a seven-month-old male infant and subsequently classified as a distinct entity in 1955 (Spence). There appears to be no hereditary pattern in multicystic renal disease in contradistinction to polycystic disease (Craig, 1962). Malformations have been described elsewhere in the body including the the urinary system, heart, blood vessels and oesophagus (Parkkulainen, Hjelt and Sirsa, 1959). The lesion may persist into adult life and be accidently discovered. Approximately 20 cases in adults have been reported and all have had unilateral changes (Lalli, 1967). Calcification occurs in about 27 per cent of cases and the excretory urogram reveals no function on the affected side (Craig, 1962). In the majority of cases the ureter is atretic or absent.

Triplication of the ureter.

Triplication of the ureter is a rare congenital anomaly which was first described in the English literature in 1931 (Lau and Henline, 1931). It is the purpose of this paper to describe an additional case which was discovered during routine investigation of a urinary tract infection. An eight-year-old girl was referred for intravenous pyelography because of repeated bouts of urinary tract infection. These episodes were associated with frequency, fever and chills. There was no incontinence or flank pain. The patient was of average height and weight for her age. Physical findings were within normal limits. Pertinent laboratory results were limited to the urinary findings where 30–40 W.B.C. per centrifuged high power field were noted and cultures yielded abundant growth of E. coli.

Triplication of the Ureter

Case history An eight-year-old girl was referred for intravenous pyelography because of repeated bouts of urinary tract infection. These episodes were associated with frequency, fever and chills. There was no incontinence or flank pain. The patient was of average height and weight for her age. Physical findings were within normal limits. Pertinent laboratory results were limited to the urinary findings where 30-40 W.B.C. per centrifuged high power field were noted and cultures yielded abundant growth of E. coli. An intravenous pyelogram revealed complete triplication on the left (Fig. 1). There were no radiographic findings of chronic pyelonephritis or other abnormality. A cystoscopic examination was subsequently performed and revealed three separate left ureteral orifices within the bladder. The patient was treated with appropriate antibiotics for one