International Journal of Recent Innovations in Medicine and Clinical Research Open Access, Peer Reviewed, Abstracted and Indexed Journal ISSN: 2582-1075 https://ijrimcr.com/ Volume-2, Issue-4, 2020: 97-100 97 Case Report Incidental Finding of Ureterocele in an Adult Female Presenting with Lower Abdominal Pain and Urinary Incontinence [Role of Imaging]: A Case Report Mohammed Danfulani* 1 , Abubakar Musa 2 , Ibrahim Haruna Gele 3 , Muhammad Baba Sule 4 , Shamsuddeen Aliyu 5 1,2,3,4,5 Department of Radiology, Faculty of Clinical Sciences, Usmanu Danfodiyo University Sokoto. * Corresponding Author Email: danfulo2005gmail.com Received: October 29, 2020 Accepted: November 18, 2020 Published: November 26, 2020 Abstract: Ureterocele is a cystic dilatation of the terminal portion of the ureter that is located inside the bladder wall or the urethra or both. It occurs with varying frequency and has a higher incidence in female with a male to female ration of 1:6. The variable clinical presentation may include loin pain, lower abdominal pain, urinary tract infection, heamaturia, urinary incontinence or retention. We present a case of adult ureterocele misdiagnosed as pelvic inflammatory disease (PID) so as highlight the role of imaging in effective management of Acute Gyneacological emergency. Keywords: Ureterocele, Lower Abdominal Pain, Urinary Incontinence, Incidental Finding. Introduction Ureterocele is a cystic dilatation of the terminal portion of the ureter that is located inside the bladder wall or the urethra or both [1]. It occurs with varying frequency and has a higher incidence in female with a male to female ration of 1:6 [2]. The variable clinical presentation may include loin pain, lower abdominal pain, urinary tract infection, heamaturia, urinary incontinence or retention [3]. We present a case of adult ureterocele misdiagnosed as pelvic inflammatory disease (PID). Case Report A 29-year old house wife who presented with 3 years history of intermittent lower abdominal pain that is sometimes associated with lower grade fever. She had no dysuria, heamaturia or vaginal discharge. She was misdiagnosed for pelvic inflammatory disease and had several course of antibiotic and analgesic with temporary relief. She was referred to Radiology Department, from UDUTH general outpatient department (GOPD) for an abdominal ultrasound. On physical examination she was afebrile, anicteric, acyanosed, not dehydrated, no pedal edema. Not in obvious respiratory distress. Chest and neurological examination were essentially within normal limits. Laboratory findings shows protein and some pus cell in the urinalysis result, however the EUCR, FBC and ESR are within normal range. Trans-abdominal ultrasound showed a small oval anechoic lesion with a smooth well circumscribed echogenic margin within the urinary bladder on the left side on a transverse scan and appears tubular structure within the moderately filled urinary bladder on a longitudinal scan (Figure 1). No back pressure effect on the kidneys and ureters bilaterally. An impression of non-obstructed ureterocele was made and subsequently intravenous urography confirms the diagnosis with evidence by the "cobra" head appearance of ureterocele (Figure 2). The patient was then referred to the urology unit where she had endoscopic incision of the lesion and was later placed on antibiotic and analgesic and subsequently was discharged. She has done well post operatively.