• Rafael Trindade Deyl, Márcio Augusto Averbeck, Gilberto Laurino Almeida, Giovani Thomaz Pioner, and Carlos Ary Vargas Souto.
• Urology Department, Santa Casa Hospital Complex, Santo Antonio Children's Hospital, Prof. Annes Dias Street, 285, Porto Alegre, Rio Grande do Sul 90020-090, Brazil.
• J Pediatr Urol. 2009 Jun 1; 5 (3): 237-9.

IntroductionAppendix interposition has been described as an option for surgical reconstruction of partial and total ureteral defects both in children and adults. However, to our knowledge, appendix interposition for a total left ureteral reconstruction has never been described.Case ReportWe report the first case of total left ureteral reconstruction with cecal appendix to connect the renal pelvis of a native kidney to the urinary bladder in a 3-month-old child with ureteral necrosis following pyeloplasty.ResultsPostoperative recovery was uneventful. Postoperative intravenous pyelogram showed good flow of dye from the pelvis past the appendicular graft into the bladder. After 6 months, the child was asymptomatic, within the normal growth curve for height and weight.ConclusionTotal ureteral reconstruction with cecal appendix is a feasible technique in young children. Surveillance for late operative complications is required, since this is the first case of total left ureteral reconstruction with appendix to connect the renal pelvis of a native kidney to the urinary bladder.

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