Pediatric patient with appendiceal interposition after ureteral stricture
Melis Cevhertas1
, Omer Baris Yucel2, Sibel Tiryaki2, Ali Tekin2, Ibrahim Ulman2
1Department of Pediatric Surgery, Ege University Faculty of Medicine, İzmir, Türkiye
2Department of Pediatric Surgery, Division of Pediatric Urology, Ege University Faculty of Medicine, İzmir, Türkiye
Keywords: Appendiceal interposition, appendix, iatrogenic, interposition, reconstruction, ureteric stricture.
Abstract
The use of the vermiform appendix as a replacement for ureteral segments has been rarely reported, particularly in children, and even more rarely in the left ureteral stenosis. Herein, a case where the appendix was successfully used to bridge a left mid-ureteral iatrogenic stricture in a child was presented. A two-year-old male with a history of ureteric stone and laser lithotripsy at six months of age presented with ongoing hydroureteronephrosis and recurrent urinary tract infections despite prophylactic antibiotics. Hydroureteronephrosis arose two months after the surgery and progressed slowly. Retrograde pyelogram revealed a stenosis in the left mid-ureter 4 cm above the iliac cross. The mesoappendix allowed the appendix to be used for interposition on the left ureter. The patient was followed with a JJ stent for two months. Ureterorenoscopy during JJ removal showed no stricture. Three years after the surgery, imaging showed improved hydronephrosis, stable function, and no obstructive findings on the nuclear renal scan. Children undergoing stone surgery should be monitored for potential complications, including strictures. Appendiceal interposition should be considered a viable treatment option for ureteric injuries, even for the left ureter.
Citation: Cevhertas M, Yucel OB, Tiryaki S, Tekin A, Ulman I. Pediatric patient with appendiceal interposition after ureteral stricture. Turkish J Ped Surg 2025;39(3):176-179. doi: 10.62114/JTAPS.2025.117.
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Idea/concept, analysis and/or interpretation: O.B.Y., S.T., A.T., I.U.; Design: M.C., O.B.Y., S.T., A.T.; Control/supervision, critical review: S.T., A.T., I.U.; Data collection and/or processing, materials: M.C., I.U.; Literature review: M.C., S.T., A.T.; Writing the article: M.C.; References and fundings: M.C., O.B.Y., S.T., A.T., I.U.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.