A case of mid-segment ureteral duplication: Uncovering a rare developmental anomaly

Ureteral duplication is a congenital anomaly often associated with urinary complications. We report a case of a 54-year-old female presenting with recurrent urinary tract infections and right flank pain. Imaging revealed a rare mid-segment ureteral duplication, where the ureter bifurcates and rejoins before entering the bladder. The anomaly was complicated by ESBL-producing Escherichia coli infection. Conservative management with antibiotics was chosen after the patient declined surgery. This case underscores the diagnostic challenges of mid-segment duplications and highlights the importance of advanced imaging in adults with unexplained recurrent urinary tract infections.