Robert L. Lebowitz, M.D. Children' s Hospital, Harvard Medical School Boston, Massachusetts

This 4 1/2-month old baby girl presented with vaginal discharge. Ultrasound showed a markedly dialated left upper pole ureter filled with debris(Figure 1 and Figure 2).Virtually no upper pole parenchyma was seen(Figure 3). At catheterization, the interlabial are was filled with pus. Catheterization of the urethra yielded clear urine. This ectopic ureter inserted into the vagina and there was no upper pole uptake on the DMSA scan.