Transplantation of the ureters into the rectum or lower portion of the sigmoid colon has been employed successfully in conditions affecting the integrity of the lower part of the urinary tract. By this means the mechanical requirements for the elimination of urine through the bowel are met. It might be expected, however, that such a procedure would lead to changes in the excretion of waste substances, affecting particularly the efficacy of acid elimination.
A patient with transplanted ureters has been observed in this clinic for three years. He has shown clinical evidences of impaired acid elimination, resulting in the development of a condition indistinguishable from active rickets. The results of studies of his condition are of interest, not only from the standpoint of their bearing on ureteral transplantation as an operative procedure, but also because of the information they offer concerning acid-base metabolism.
REPORT OF CASE
History.—W. B., a