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Intamural Ectopic Ureter

Patient Information

Age
7 Months
Gender
Female, Spayed
Species
Canine

History

7-month-old FS Labrador Retriever presented with persistent dysuria and incontinence. The UA revealed UTI with E. coli on culture.

Sonographic Differential Diagnosis

Differential Diagnosis: Intestinal lymphoma, mast cell disease,IBD, FIP, carcinoma less likely.

Sampling

Laparotomy was performed with intraoperative imaging of the intestinal tract in order to isolate the small intestinal thickening of the muscularis. A focal region of intestinal perforation was present without significant serosal changes and minor surgically palpable thickening of the segment in question. The surgeon resected of the portion of the bowel that contained thickened muscularis according to the intraoperative sonographer's direction. Full thickness biopsy of the small intestine with normal muscularis thickness was also obtained as well as mesenteric lymph node and liver. Samples were placed in separate biopsy jars and labeled accordingly as to the sonographic presentation. Histopath: Intestine with muscularis thickening: First read was interpreted as intramural lymphocytic enteritis with muscularis hypertrophy. Second opinion interpretation: Low grade, diffuse, mucosal intestinal lymphoma with muscularis hypertrophy and mild multifocal submucosal and muscularis lymphoid infiltrate. Lymph node: low grade mast cell neoplasia. Liver: Moderate chronic lymphocytic hepatitis.

Comments

The patient was not symptomatic at a 1 month follow-up visit.   Referring Practitioner: Dean Cerf DVM, Ridgewood Veterinary Hospital, Ridgewood, NJ, USA.

Videos

Intramural ectopic ureter in contracting as it empties into the proximal urethra. Linear 12 MHz probe.
Cross sectional view of the right ectopic ureter starting from the point of entry into the proximal urethra and continuing cranially along the body of the bladder. Linear 12 MHz probe.
Long axis deep pelvic urethral view demonstrating the ectopic ureter papilla entry into the urethra. Linear 12 MHz probe.
7 days post surgical correction of the right intramural ectopic ureter. Slight periurethral inflammation is present (hyperechoic ill defined pelvic fat) due to surgical intervention. Linear 12 MHz probe.