Lower pole ureteral obstruction secondary to fecal impaction in an 8-year-old girl.

An 8-year-old girl presented with frequent, nonfebrile, urinary tract infections and a lifelong history of severe constipation. Ultrasound revealed bilateral duplicated renal systems, severe right upper pole hydronephrosis, and moderate left lower pole hydronephrosis. Computerized tomographic scan revealed a large, fecal-impacted colon. Diuretic renogram showed high-grade obstruction (T1/2 >30 minutes) of the right upper pole and left lower pole moieties. After administering an aggressive bowel preparation, a repeat diuretic renogram was performed, which revealed resolution of the left lower pole obstruction. Constipation has long been established as a contributing factor to urinary tract infections in children. However, fecal impaction causing ureteral obstruction in a child has not been reported. We report the case of an 8-year-old girl who had left lower pole ureteral obstruction secondary to fecal impaction.