Presentation
Colicky abdominal pain, radiating to the lumbar spine.
Patient Data
Horseshoe kidney with a 6 mm stone at the right ureterovesical junction (UVJ). There is dilatation of the upstream collection system with stranding and a small amount of free fluid anterior to the right renal pelvis and proximal ureter, compatible with rupture and urine leak into the peritoneal space.
The left-sided collecting system is not dilated.
The appendix is normal.
Case Discussion
Persons with horseshoe kidneys are at higher risk for renal calculi than the average population (~20% lifetime risk). Because of the ectopic exit of the ureters from the horseshoe kidney, the increased risk of stones has been thought to be due to urine stasis rather than abnormalities of the renal parenchyma. Some think that a combination of relative urinary stasis and metabolic abnormalities in the horseshoe kidney are required for stone formation.
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