# Mid-ureteric Ectasia Masquerading as Hirschsprung Disease: A Rare Cause of Infantile Large Bowel Obstruction

## TL;DR

A rare case of mid-ureteric ectasia in an infant was mistaken for a bowel obstruction, highlighting the need to consider this condition in similar presentations.

## Contribution

This case report highlights mid-ureteric ectasia as a rare but important differential diagnosis for infantile bowel obstruction and abdominal masses.

## Key findings

- Mid-ureteric ectasia can mimic large bowel obstruction in infants.
- Surgical excision and anastomosis resolved the obstruction caused by the cystic dilatation.
- Normal peristaltic activity was observed in the non-dilated ureteric segments.

## Abstract

Mid-ureteric dilatation with stenosis is extremely rare in children. We discuss a case of a three-month-old infant presenting with a large bowel obstruction and a left-sided abdominal lump. While the large bowel was grossly normal on exploration, a cystic dilatation in the middle of the ureter was causing colonic compression, with the proximal and distal ureteric segments being normal in diameter and exhibiting normal peristaltic activity. Thus, an unusual segmental cystic dilatation of the ureter with stenosis was noted. Excision of the dilated segment of the ureter and end-to-end ureteric anastomosis was performed. Though rare, mid-ureteric ectasia can masquerade as colonic obstruction and should be considered as a differential diagnosis for constipation and left-sided abdominal masses in infancy.