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Table 1 Review of previously published cases of ureteral intussusception

From: A case of flank pain caused by ureteral intussusception accompanied with ureteral polyp

Author Year Age/Sex Number Aetiology Lesion Location Location of pain Hematuria Hydronephrosis NCCT CECT CTU IVU Treatment
Dix [1] 1937 54/M 1 Papilloma L /Pe-ureter No Yes Yes N/A N/A N/A No visualization of left ureter Nephrouretectomy
Morley et al. [2] 1952 19/M 1 Fibrous ureteral polyp R /Pe-ureter Right flank No Yes N/A N/A N/A The middle ureter is dilated with filling defects, the lower ureter appears normal Nephrouretectomy (The length of the involved ureter is too long to permit reanastomosis)
Bonomini et al. [3] 1963 20/M 1 Benign pedunculated polyp L /Pe-ureter Left flank Yes Yes N/A N/A N/A The middle third of the ureter is dilated and occupied with defects of filling Segmental resection of the ureter with reanastomosis
Gerdes et al. [4] 1966 34/F 1 Angiofibromatous polyp N/A Diffuse abdomen Yes No N/A N/A N/A N/A N/A
Mazer et al. [5] 1979 66/M 1 TCC R /Pe-ureter No Yes Yes N/A N/A N/A A “bell-shaped” filling defect Local excision of the tumour was performed with reconstruction of the ureter
Fiorelli et al. [6] 1981 25/F 1 Fibroepithelial polyp L /UPJ Left flank No Yes N/A N/A N/A Ureteral defect and easy flow of contrast medium around it are barely visible. Resection of the pyeloureteral junction that was shoved into distal ureter after lysis of outer fibrous band was performed followed by an Anderson-Hynes pyeloplasty
Vogelzang et al. [7] 1981 27/M 1 Fibrous ureteral polyp L /Pe-ureter Left flank Yes Yes N/A N/A N/A Moderate dilatation in the proximal ureter, no contrast passed into intussusception Tumor excision by ureterotomy, no detail
Fukushi et al. [8] 1983 59/F 1 Inflanmmatory Polyp L /Pe-ureter Left flank Yes Yes N/A N/A N/A “Claw of crab -shaped” contrast filling sign Intussusception was repaired after lysis of the external adhesion of the invaginated region
Takeuchi et al. [9]# 1984 70/M 3 TCC (×3) R /Ab-ureter No Yes Yes N/A “Concentric sign” in ureter and a large mass in bladder (×1) N/A A dilatation in the lower ureter with filling defect of varied size, protruding into bladder Segmental ureterectomy (×1), combined with partial bladder resection (× 1) or radical cystectomy (× 1)
71/M L /Ab-ureter and bladder
52/M R /Ab-ureter
Haupert et al. [10]# 1985 N/A 1 Fibroepithelial polyp N/A N/A N/A N/A N/A N/A N/A N/A Segmental resection of the ureter with reanastomosis
Compton et al. [11] 1986 50/M 1 TCC R /Pe-ureter No Yes No N/A N/A N/A A fusiform dilatation in the mid- ureter Segmental resection of the ureter with reanastomosis
Gabriel et al. [12] 1986 74/M 1 TCC R /Pe-ureter Right lower abdomen No Yes N/A N/A N/A A local widening with irregular filling defect proximal to the ureterovesical junction Nephroureterectomy including a cuff of urinary bladder
Moretti et al. [13] 1987 59/M 1 TCC R /Pe-ureter No Yes Yes N/A N/A N/A A tubular nonopaque filling defect within dilated lower ureter that contains apparently calcified polyp Intussusception was reduced after local excision of the tumour in ureter
Duchek et al. [14] 1987 24/M 1 Papilloma R /Pe-ureter Right flank Yes Yes N/A N/A N/A A local widening in the middle ureter with irregular filling defect Partial resection of the ureter with reanastomosis
Radhi [15] 1992 N/A 1 TCC N/A N/A N/A N/A N/A N/A N/A N/A N/A
Png et al. [16] 1995 26/F 1 Fibroepithelial polyp R /Ab-ureter Right flank Yes Yes N/A N/A N/A A filling defect in the ureter Segmental resection of the ureter with reanastomosis
Bernhard et al. [17] 1996 45/M 1 Latrogenic 1 L /Pe-ureter Left flank N/A Yes N/A N/A N/A A filling defect in the mid-ureter Partial resection of the ureter and construction of a Boari flap
el Khader et al. [18]# 1997 30/F 1 Latrogenic 2 - /UPJ N/A N/A N/A N/A N/A N/A N/A Segmental resection of the ureter with calicoureterostomy
de La Taille et al. [19] 1998 59/M 1 TCC R /Ab-ureter No Yes Yes A ureteral mass N/A N/A Ureteral fusiform enlargement containing an oval filling defect Nephrouretectomy
Liu et al. [20] 2000 63/M 1 Latrogenic 3 R /Ab-ureter N/A Yes Yes N/A N/A N/A N/A The intussusception was recognized at the time and was reduced completely with hydrostatic pressure and performed with use of fluoroscopic guidance and conscious sedation.
Chiong et al. [21] 2004 15/M 1 Latrogenic 4 R /UPJ N/A N/A Yes N/A N/A N/A A “bell-shaped” filling defect at the distal part of the upper ureter Segmental resection of the obstructing ureter with Culp-De-Weerd pyeloplasty reconstruction
Xu et al. [22] 2007 49/M 1 Fibroepithelial polyp R /Pe-ureter Right flank Yes No An enlargement in the inferior part of the invaginated ureter “Concentric sign” N/A The wall of the intussuscepted ureter appeared as a cylindrical filling defect in the dilatated ureteral lumen. Invaginated ureteral lumen is filled with contrast material and appeared as a “line” sign in the intussusception Segmental resection of the ureter with reanastomosis
Jin et al. [23] 2011 63/F 1 Massive fibroepithelial polyp R /Pe-ureter No Yes No N/A “Concentric sign” A filling defect in lower enlarged ureter A “sponge-like” filling defect in lower enlarged ureteral segment and an “oval-shaped” filling defect of the ureteral orifice inside the bladder Segmental resection of the ureter with reanastomosis via a laparoscopic approach
Hasegawa et al. [24] 2011 39/F 1 Fibroepithelial Polyp R /Pe-ureter Right flank No No A ureteral mass N/A N/A A “tongue-like” filling defect in the ureter Segmental resection of the ureter with reanastomosis via a retroperitoneoscopic approach
Chao et al. [25] 2012 64/M 1 TCC R /Pe-ureter Epigastric No Yes A ureteral mass “Bull’s-eye sign” A “stalk-of-corn” appearance on coronal and sagittal imaging N/A Nephrouretectomy
Sewell et al. [26] 2015 70/M 1 Calculus L /Pe-ureter No No Yes A 8 mm calculus N/A N/A A “goblet sign” contrast filling on retrograde pyelography Ureteropyeloscopic lithotripsy with laser
Suzuki et al. [27] 2015 67/M 1 Fibroepithelial polyp R /Pe-ureter No Yes Yes N/A “Concentric sign” A linear contrast in the invaginated proximal ureter Invaginated ureteral lumen is filled with contrast material and appeared as a “line-shaped” sign in the intussusception Segmental resection of the ureter with reanastomosis
Hajji et al. [28] 2019 42/M 1 Fibroepithelial polyp L /Ab-ureter Right abdomen No No N/A A ureteral mass protruding into bladder N/A A “bell-shaped” filling defect and a “V-shaped” ureter filled with contrast in the upstream from the mass Resection of the polyp with its stalk by ureteroscopic electrocauterisation
This case 2020 56/M 1 Fibroepithelial polyp R/Ab-ureter Right flank and lower abdomen Yes No A ureteral mass N/A N/A A “sponge-like” filling defect in lower enlarged ureteral lumen and ureteral orifice inside the bladder Ureteroscopic cauterization of partial polyp followed by open surgery for segmental resection of the ureter with reanastomosis
  1. Note: #: only English abstract available, NCCT non-contrast CT, CECT contrast-enhanced CT (on axial imaging), CTU CT urography; Ab-ureter: abdominal part of ureter, Pe-ureter pelvic part of ureter, UPJ ureteropelvic junction, L left, R right, TCC Transitional cell carcinoma, N/A not applicable
  2. Latrogenic 1: secondary to ureteroscopy; Latrogenic 2: secondary to double CH endoprosthesis; Latrogenic 3; secondary to percutaneous nephrostomy catheter exchange (retrograde intussusception); Latrogenic 4: secondary to percutaneous endopyelotomy for UPJ obstruction