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Supernumerary kidney presenting as urinary leakage after an ipsilateral laparoscopic radical nephrectomy.

Roslan M, Markuszewski MM, Kułagin A, Markuszewski MR, Połom W, Krajka K - Cent European J Urol (2012)

Bottom Line: We present a case of a patient with supranumerary kidney diagnosed after laparoscopic radical nephrectomy.The latter right nephrectomy was performed.Despite the scarceness of this anomaly, a thorough interpretation of images obtained during investigative procedures can provide a clue about the presence of this rare entity.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Medical University of Gdańsk, Gdańsk, Poland.

ABSTRACT
We present a case of a patient with supranumerary kidney diagnosed after laparoscopic radical nephrectomy. Urinary leakage, an unusual complication that appeared postoperatively, led to complementary examination and making the right diagnosis. The reevaluation of the preoperative CT (computed tomography) in enhancement phase and the new CT scan confirmed the presence of a real accessory organ connected to the main unit with a small bridge of tissue. The latter right nephrectomy was performed. Despite the scarceness of this anomaly, a thorough interpretation of images obtained during investigative procedures can provide a clue about the presence of this rare entity.

No MeSH data available.


Related in: MedlinePlus

Postoperatively reevaluated initial CT scan. A contrast-enhanced arterial phase oblique image shows clearly the separation of the units.
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Figure 0004: Postoperatively reevaluated initial CT scan. A contrast-enhanced arterial phase oblique image shows clearly the separation of the units.

Mentions: On the 14-day follow-up visit the patient was in good condition, but the daily amount of bright yellow fluid collected from the drain increased gradually up to 350 ml. The examination of the fluid showed the creatinine level of 101 mg/dL. The fluid was considered to be urine. A new CT scan and reassessment of initial exams was carried out. The reevaluation of the preoperative CT in the enhancement phase revealed the accessory organ located cranially to the right kidney with a small bridge of tissue binding those two together. A separate upper ureter was also visualized (Fig. 2a, b). A new CT exam revealed the presence of a 6-cm long properly functioning kidney situated below and behind the liver. This kidney had normal renal vasculature from the aorta and inferior vena cava (Fig. 3a, b). A true supernumerary kidney was recognized and the patient was operated on after a few days. The operation started with the laparoscopic approach, however due to some difficulties in dissecting the kidney it was completed in an open manner. The removed organ was typically reniform but smaller than the normal kidney and its capsule seemed to be intact. A short ureter entered to remnant of the main pelvis, which was cut off and left during the first operation (Fig. 4). The postoperative period was uneventful and the patient was discharged on the fourth day.


Supernumerary kidney presenting as urinary leakage after an ipsilateral laparoscopic radical nephrectomy.

Roslan M, Markuszewski MM, Kułagin A, Markuszewski MR, Połom W, Krajka K - Cent European J Urol (2012)

Postoperatively reevaluated initial CT scan. A contrast-enhanced arterial phase oblique image shows clearly the separation of the units.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921760&req=5

Figure 0004: Postoperatively reevaluated initial CT scan. A contrast-enhanced arterial phase oblique image shows clearly the separation of the units.
Mentions: On the 14-day follow-up visit the patient was in good condition, but the daily amount of bright yellow fluid collected from the drain increased gradually up to 350 ml. The examination of the fluid showed the creatinine level of 101 mg/dL. The fluid was considered to be urine. A new CT scan and reassessment of initial exams was carried out. The reevaluation of the preoperative CT in the enhancement phase revealed the accessory organ located cranially to the right kidney with a small bridge of tissue binding those two together. A separate upper ureter was also visualized (Fig. 2a, b). A new CT exam revealed the presence of a 6-cm long properly functioning kidney situated below and behind the liver. This kidney had normal renal vasculature from the aorta and inferior vena cava (Fig. 3a, b). A true supernumerary kidney was recognized and the patient was operated on after a few days. The operation started with the laparoscopic approach, however due to some difficulties in dissecting the kidney it was completed in an open manner. The removed organ was typically reniform but smaller than the normal kidney and its capsule seemed to be intact. A short ureter entered to remnant of the main pelvis, which was cut off and left during the first operation (Fig. 4). The postoperative period was uneventful and the patient was discharged on the fourth day.

Bottom Line: We present a case of a patient with supranumerary kidney diagnosed after laparoscopic radical nephrectomy.The latter right nephrectomy was performed.Despite the scarceness of this anomaly, a thorough interpretation of images obtained during investigative procedures can provide a clue about the presence of this rare entity.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Medical University of Gdańsk, Gdańsk, Poland.

ABSTRACT
We present a case of a patient with supranumerary kidney diagnosed after laparoscopic radical nephrectomy. Urinary leakage, an unusual complication that appeared postoperatively, led to complementary examination and making the right diagnosis. The reevaluation of the preoperative CT (computed tomography) in enhancement phase and the new CT scan confirmed the presence of a real accessory organ connected to the main unit with a small bridge of tissue. The latter right nephrectomy was performed. Despite the scarceness of this anomaly, a thorough interpretation of images obtained during investigative procedures can provide a clue about the presence of this rare entity.

No MeSH data available.


Related in: MedlinePlus