DOI: http://dx.doi.org/10.18203/2349-2902.isj20200852

Post traumatic ureteral defect brigded with ileal segment (Yang-Monti) for inferior ureterocalycostomy: a rare case report with review of literature

Debanga Sarma, Rajeev T. P., Ashish Ghanghoria, Sasanka Kumar Barua, Puskal Kumar Bagchi, Mandeep Phukan

Abstract


Ureteric substitution using the Yang-Monti principle was reported as a modification of simple ileal ureter replacement. A patient underwent ileal ureteral substitution using a reconfigured ileal segment of Yang-Monti principle in our clinical centre. Authors report a case of a 41year old male involved in a homicidal stab injury with isolated renal pelvis injury underwent Thompson’s renal capsular flap repair. After 6 weeks, double J (DJ) stent was removed and following that patient developed urinoma. Percutaneous drain was placed to drain urinoma on emergency basis and again 6 Fr DJ stent was inserted but patient had recurrent fever and chills. On CECT evaluation authors noticed that DJ stent was outside the upper urinary tract. And then patient was re-explored where authors found 6 cm stricture of the proximal left ureter. A reconfigured small bowel tube was interposed between inferior calyx and proximal ureteral stumps. This technique offers certain distinct advantages. A short ileal segment is included with the consequent absence of metabolic complications. Yang-Monti Principle is a safer and efficient technique for clinical partial and complete ureteral defects with sustained, good, long-term results. Yang-Monti reconfigured tube seems to be promoted an equally efficient urine transport mechanism that persists unaltered for long periods if patients and potential risks could be well prepared.


Keywords


Ileum, Reconstruction, Ureter, Ureteral substitution, Yang-Monti

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