Open Heminephrectomy in Unilateral Duplex Collecting System: A Case Report

Alaa Emtir; Abdussalam Muftah; Tarik Abulhul

doi:10.69667/lmj.2517202

Authors

Alaa Emtir Department of Urology, Tripoli Central Hospital, Tripoli, Libya https://orcid.org/0000-0002-6114-5698
Abdussalam Muftah Department of Urology, Tripoli Central Hospital, Tripoli, Libya https://orcid.org/0000-0002-4505-6468
Tarik Abulhul Department of Urology, Tripoli Central Hospital, Tripoli, Libya https://orcid.org/0000-0001-6512-8695

DOI:

https://doi.org/10.69667/lmj.2517202

Keywords:

Heminephrectomy, Double Collecting System, Kidney.

Abstract

A duplicated collecting system, characterized by the presence of two separate pelvicalyceal systems within a single kidney, is a rare congenital anomaly. Surgical intervention, such as open heminephrectomy, is often required in cases where complications arise, including recurrent infections, significant obstruction, or reflux. We report the case of a 29-year-old female who presented with recurrent urinary tract infections and flank pain with reflux. Imaging studies revealed a duplicated collecting system on the right side with significantly poor functioning upper moiety while preserving the healthy lower moiety. The patient tolerated the procedure well, with no intraoperative complications. Postoperative recovery was uneventful, and follow-up imaging confirmed the successful removal of the affected renal segment. The patient remained symptom-free at the two-month follow-up. Open heminephrectomy remains a viable surgical option for managing a symptomatic duplicated collecting system.

يُعدّ ازدواج نظام التجميع، الذي يتميز بوجود نظامين منفصلين للكلية الحوضية داخل كلية واحدة، عيبًا خلقيًا نادرًا. غالبًا ما يكون التدخل الجراحي، مثل استئصال نصف الكلية المفتوح، ضروريًا في الحالات التي تظهر فيها مضاعفات، بما في ذلك الالتهابات المتكررة أو الانسداد الشديد أو الارتجاع. نُبلغ عن حالة امرأة تبلغ من العمر 29 عامًا عانت من التهابات متكررة في المسالك البولية وألم في الخاصرة مع ارتجاع. كشفت دراسات التصوير عن وجود نظام تجميع مكرر على الجانب الأيمن مع ضعف كبير في أداء الجزء العلوي مع الحفاظ على سلامة الجزء السفلي. تحمّلت المريضة الإجراء جيدًا، دون أي مضاعفات أثناء الجراحة. كان التعافي بعد الجراحة هادئًا، وأكدت صور المتابعة نجاح إزالة الجزء الكلوي المصاب. ظلت المريضة خالية من الأعراض في فترة المتابعة التي استمرت شهرين. يظل استئصال نصف الكلية المفتوح خيارًا جراحيًا فعالًا لإدارة نظام التجميع المكرر المصحوب بأعراض

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