Detection of ureterocele in distal ureteric stump following nephrectomy on diuretic renal scan and SPECT/CT

A 10 years old girl with complain of hematuria and recurrent febrile urinary tract infection (UTI), with a history of bilateral vesicoureteric reflux (VUR) leading to nephrectomy as a result of a non-functional left kidney 3 yrs previously , was referred to our department for diuretic renal scan. The study showed normal function of the right kidney, normal excretion of the tracer from pyelocalyceal (PC) system, along with a small ibsilateral cortical defect. No active renal tissue was noted on the left side. Post void images showed a collection of activity on the left side of the bladder. The SPECT/CT also demonstrated this collection of activity on the same region compatible with post nephrectomy distal ureteral stump. Our case study revealed the diuretic renal scan can be of help in detection of ureterocele in post nephrectomy remained distal ureteral stump which might present with symptoms such as pain and hematuria. In addition our case underscores the importance of SPECT/CT for reaching a correct diagnosis in these patients.