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.
Cevhertaş et al. (Mon,) studied this question.