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

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.