A 3½-year-old boy in Afghanistan went into surgery for what an ultrasound had shown as a kidney with two drainage systems, the upper one badly swollen. Once the operation began, surgeons found three ureters, the tubes that carry urine from the kidney to the bladder. The boy had ureteral triplication, a birth anomaly so rare that the authors put the worldwide total at fewer than 100 reported cases.
The case was published May 7 in the International Journal of Surgery Case Reports by pediatric surgeons at Afghan Arya Specialty Hospital in Herat. The authors used it to highlight a practical problem: where advanced scans are hard to get, rare anatomy can stay hidden until the operating table.
