• Ning Xiao, Bo Ge, JianFeng Wang, and HuaSheng Zhao.
• Department of Urology Continence Research Clinic Medical Laboratory Center, The Central Hospital of ShaoYang, University of South China, ShaoYang Department of Urology, The Second Affiliated Hospital of GuiLin Medical University, GuiLin, China.
• Medicine (Baltimore). 2018 Jul 1; 97 (30): e11474e11474.

RationaleThe duplex ureter is a common anomaly of urinary tract, but preoperative sonography, plain abdominal radiography, or nonenhanced computed tomography (CT) often overlooked it when involved with urinary tract obstruction. In this report, We present a rare case of left Y-shaped bifid ureter and both ureter of upper moiety and common stem were obstructed respectively by 2 calculi.Patient ConcernsA 47-year-old woman was admitted due to 3-day history of left-sided loin pain and low-grade fever. The patient was diagnosed with right renal atrophy and 2 calculi of left ureter associated with severe left hydronephroureterosis, and underwent left percutaneous nephrostomy and left ureterolithotomy without identification of the upper calculus in left ureter in another hospital.DiagnosesAfter transfer of the patient to our hospital, preoperative contrast-enhanced CT detected the left Y shaped bifid ureter and the calculus in upper moiety ureter.InterventionsThe migrated calculus was extracted by left ureterolithotomy.OutcomesThe patient discharged uneventfully.LessonsContrast-enhanced CT should be recommended prior to any surgical procedures involved with upper urinary tract to exclude duplex ureter.

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