Ureteric Calculus in a Left Complete Duplex System Masquerading as an Impacted Stone: A Case Report and Literature Review

Ureteric calculi are common urological problems. However, the management of stone disease varies considerably with patient choice and anatomy. There are few reports about ureteral calculi in patients with unilateral complete duplex kidneys managed by ureteroscopy. We hope to increase the awareness of urologists when investigating patients with similar symptoms. We present the case of a 28-year-old man with recurring left flank pain. Non-contrast computed tomography (CT) scans of the kidney showed an impacted left vesicoureteric junction stone measuring 6 mm. Intra-operatively, a stone in the left duplex system was discovered. He was managed with ureteroscopy, laser fragmentation, and the insertion of ureteric stents. The case demonstrates the complexity of managing ureteric stones in a complete duplex kidney. We highlighted the diagnostic limitations of non-contrast scans in identifying duplex systems. It is important to consider contrast CT scans in patients with unusually persistent symptoms to outline the anatomy of the kidney and collecting systems.