Multicystic dysplastic kidney with twice duplicated distal ureter having ectopic blind endings

During dissection, retro peritoneum of intra uterine dead (IUD) male fetus of 28 weeks gestation a combination of multicystic dysplastic kidney with a rare ureteral anomaly that is not seen frequently was observed. The normal left renal anatomy was completely distorted. Ureter divided twice in an inverted “Y” branching pattern, the two left limbs entered the wall of rectum and urinary bladder of same side respectively and right limb opened ectopically into urinary bladder. The gross and microscopic features were in favor of Multicystic Dysplastic Kidney and Ureter. Congenital renal dysplasia may be explained by an abnormal induction of metanephric blastema by migrating ureteric bud. The embryological basis of inverted “Y” shaped ureter is not clearly understood, we suggest that it is due to longitudinal splitting of ureteric bud. This type of anomaly of the ureter may represent real traps in the interpretation of abdominal imaging, particularly in CT scanning.