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Laparoscopic pyeloplasty for ureteropelvic junction obstruction in crossed fused ectopic pelvic kidney.

Muruganandham K, Kumar A, Kumar S - Korean J Urol (2014)

Bottom Line: Crossed fused renal ectopia is a rare anomaly and may be associated with pelvic ureteric junction obstruction (PUJO).We report such a case with a crossed fused ectopic pelvic kidney (L-type) with PUJO and its successful laparoscopic management.Through this report we emphasize the importance of adequate preoperative imaging and intraoperative details to avoid mishaps.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, JIPMER (Jawaharlal Institute of Postgraduate Medical Education & Research), Puducherry, India.

ABSTRACT
Crossed fused renal ectopia is a rare anomaly and may be associated with pelvic ureteric junction obstruction (PUJO). The L-shaped fusion variety is even rarer. We report such a case with a crossed fused ectopic pelvic kidney (L-type) with PUJO and its successful laparoscopic management. Through this report we emphasize the importance of adequate preoperative imaging and intraoperative details to avoid mishaps.

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Related in: MedlinePlus

Computed tomography (CT) scan (A) and single-photon emission CT scan (B) showing crossed fused ectopic pelvic kidney with hydronephrosis on left side.
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Figure 3: Computed tomography (CT) scan (A) and single-photon emission CT scan (B) showing crossed fused ectopic pelvic kidney with hydronephrosis on left side.

Mentions: A 16-year-old female was admitted with complaints of right-side lower abdominal pain of a dull aching type lasting 6 months. Physical examination revealed no palpable lumps. On further evaluation, ultrasonography revealed bilateral kidneys absent in the renal fossa and found in the pelvis. These findings were confirmed with an intravenous pyelogram, which showed the right kidney low lying in the lumbar and pelvic region, malrotated, and normally excreting and the left kidney pelvic in location, grossly hydronephrotic, and crossing the midline (Fig. 1). A contrast-enhanced computed tomography (CT) scan showed a bilateral ectopic kidney with the L-type fusion, grossly dilated left renal pelvis, and the right ureter crossing over the left dilated pelvis (Fig. 2). Renal scintigraphy with LLEC (L-ethylcysteine) with single-photon emission CT (SPECT) (Fig. 3) showed left-sided crossed fused pelvic ectopic kidney with features suggestive of PUJO. The right kidney was also present in an ectopic location in the lumbar-pelvic region with an overall L-shape configuration. CT angiography revealed no crossing vessel as the cause of PUJO. Urine was sterile and the results of renal function tests were normal.


Laparoscopic pyeloplasty for ureteropelvic junction obstruction in crossed fused ectopic pelvic kidney.

Muruganandham K, Kumar A, Kumar S - Korean J Urol (2014)

Computed tomography (CT) scan (A) and single-photon emission CT scan (B) showing crossed fused ectopic pelvic kidney with hydronephrosis on left side.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4231155&req=5

Figure 3: Computed tomography (CT) scan (A) and single-photon emission CT scan (B) showing crossed fused ectopic pelvic kidney with hydronephrosis on left side.
Mentions: A 16-year-old female was admitted with complaints of right-side lower abdominal pain of a dull aching type lasting 6 months. Physical examination revealed no palpable lumps. On further evaluation, ultrasonography revealed bilateral kidneys absent in the renal fossa and found in the pelvis. These findings were confirmed with an intravenous pyelogram, which showed the right kidney low lying in the lumbar and pelvic region, malrotated, and normally excreting and the left kidney pelvic in location, grossly hydronephrotic, and crossing the midline (Fig. 1). A contrast-enhanced computed tomography (CT) scan showed a bilateral ectopic kidney with the L-type fusion, grossly dilated left renal pelvis, and the right ureter crossing over the left dilated pelvis (Fig. 2). Renal scintigraphy with LLEC (L-ethylcysteine) with single-photon emission CT (SPECT) (Fig. 3) showed left-sided crossed fused pelvic ectopic kidney with features suggestive of PUJO. The right kidney was also present in an ectopic location in the lumbar-pelvic region with an overall L-shape configuration. CT angiography revealed no crossing vessel as the cause of PUJO. Urine was sterile and the results of renal function tests were normal.

Bottom Line: Crossed fused renal ectopia is a rare anomaly and may be associated with pelvic ureteric junction obstruction (PUJO).We report such a case with a crossed fused ectopic pelvic kidney (L-type) with PUJO and its successful laparoscopic management.Through this report we emphasize the importance of adequate preoperative imaging and intraoperative details to avoid mishaps.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, JIPMER (Jawaharlal Institute of Postgraduate Medical Education & Research), Puducherry, India.

ABSTRACT
Crossed fused renal ectopia is a rare anomaly and may be associated with pelvic ureteric junction obstruction (PUJO). The L-shaped fusion variety is even rarer. We report such a case with a crossed fused ectopic pelvic kidney (L-type) with PUJO and its successful laparoscopic management. Through this report we emphasize the importance of adequate preoperative imaging and intraoperative details to avoid mishaps.

Show MeSH
Related in: MedlinePlus