Appendicocalicostomy: A case of mistaken identity

Anatomical structures with similar appearance may at times be confused for each other. This situation can be compounded by lack of normal anatomical planes. We did ureterocalicostomy on a 32-year-female with secondary pelvi-ureteral junction obstruction. Post-operatively, it was discovered that she had a long appendix running parallel to ureter in retroperitoneum, which was misidentified as ureter and anastomosed to the lower pole of the kidney. She was re-explored, appendix was removed, ureter was identified and ureterocalicostomy was done. Patient is asymptomatic at 1 year follow-up.