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Horseshoe Kidney (midline renal fusion)

USU Teaching File MUTF - MedPix (2006)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Horseshoe Kidney (midline renal fusion)

History: Editor's note: Although no history was provided by the author of this case file, in all likelyhood this patient presented with a history of recurrent urinary tract infection. Ureterovesicular junction obstruction is commonly associated with this entity due to abnormal insertions of the ureters into the bladder. UPJ obstructions is also common and duplicated ureters may also be present. In this patient, note the double ureter on the right. Together, these abnormalities lead to hydronephrosis, recurrent infections and stone fomation.

Findings: CT shows that the isthmus of the horseshoe kidney is thick and enhances to the same degree as the rest of the kidney, proving it to be functioning renal tissue rather than simply a fibrous band. Notice that the isthmus of the horseshoe kidney is constrained by the inferior mesenteric artery, the structure that prevented tis continued ascention within the abdomen. Note on conventional angiography that supernumary renal arteries are present bilaterally, a common finding associated with this entity. Note the severe bilateral hydronephrosis secondary, in all likelyhood, to severe vesicoureteric reflux. the IUP show a duplicated ureter on the right.

Ddx: Spinal bifida can also cause severe bilateral hydronephrosis but the angiographic picture here is classic and this diagnosis is an "Aunt Minnie"

Dxhow: Conventional angiography and CT

Exam: No physical examination or labratory data was provided by the author of this file. One can safely assume however, that secondary to the degree of hydronephrosis seen bilaterally, the patient's creatinine level is elevated. Some patient's with horseshoe kidney's exhibit a physical finding called Rovsing sign which is nausea, vomiting, and abdominal pain with hyperextension of the spine. Some patients may have a palpable lump in their abdomen.

No MeSH data available.


HORSESHOE KIDNEY
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MPX1261_synpic15904: HORSESHOE KIDNEY


Horseshoe Kidney (midline renal fusion)

USU Teaching File MUTF - MedPix (2006)

HORSESHOE KIDNEY
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1261&req=5

MPX1261_synpic15904: HORSESHOE KIDNEY

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Horseshoe Kidney (midline renal fusion)

History: Editor's note: Although no history was provided by the author of this case file, in all likelyhood this patient presented with a history of recurrent urinary tract infection. Ureterovesicular junction obstruction is commonly associated with this entity due to abnormal insertions of the ureters into the bladder. UPJ obstructions is also common and duplicated ureters may also be present. In this patient, note the double ureter on the right. Together, these abnormalities lead to hydronephrosis, recurrent infections and stone fomation.

Findings: CT shows that the isthmus of the horseshoe kidney is thick and enhances to the same degree as the rest of the kidney, proving it to be functioning renal tissue rather than simply a fibrous band. Notice that the isthmus of the horseshoe kidney is constrained by the inferior mesenteric artery, the structure that prevented tis continued ascention within the abdomen. Note on conventional angiography that supernumary renal arteries are present bilaterally, a common finding associated with this entity. Note the severe bilateral hydronephrosis secondary, in all likelyhood, to severe vesicoureteric reflux. the IUP show a duplicated ureter on the right.

Ddx: Spinal bifida can also cause severe bilateral hydronephrosis but the angiographic picture here is classic and this diagnosis is an "Aunt Minnie"

Dxhow: Conventional angiography and CT

Exam: No physical examination or labratory data was provided by the author of this file. One can safely assume however, that secondary to the degree of hydronephrosis seen bilaterally, the patient's creatinine level is elevated. Some patient's with horseshoe kidney's exhibit a physical finding called Rovsing sign which is nausea, vomiting, and abdominal pain with hyperextension of the spine. Some patients may have a palpable lump in their abdomen.

No MeSH data available.