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Pelvic kidneys, sometimes known as a sacral kidney, are kidneys that is fixed in the bony pelvis or across the spine and are an anatomic variant 1.
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Pelvic ectopia is seen in 1 in 2,100-3,000 autopsies. It is considered the most common form of renal ectopia 4.
Ectopic kidneys are often associated with other abnormalities such as agenesis of the opposite kidney, vascular malformations and genital anomalies.
Other uncommon associations include:
These patients tend to be asymptomatic and often the diagnosis is incidental on an imaging test performed for a reason unrelated to the renal tract.
Renal tract pathology (e.g. infection, calculus) can affect pelvic kidneys and thus the referred pain is not typical for the renal tract and it may be confused for other abdominopelvic pathology, e.g. appendicitis or pelvic inflammatory disease.
Other signs and symptoms of ectopic kidneys include:
palpable abdominal or pelvic mass
renovascular hypertension secondary to an anomalous blood supply (from the iliac (common/external/iliac) arteries)
dystocia from a pelvic kidney
The vascular supply of pelvic kidneys is highly variable, mainly due to it retaining its fetal blood supply. Single, dual and triple supply have been reported originating from the aortic bifurcation, the common iliac and the internal iliac arteries 5.
- 1. Thomas G, BARTON JC. Ectopic pelvic kidney. JAMA. 1936;106(3):197-201
- 2. Kakitsubata Y, Kakitsubata S, Watanabe K, Natsuda Y, Miyanaga I. Pelvic Kidney Associated with Other Congenital Anomalies: US and CT Manifestations. Radiat Med. 1993;11(3):107-9. - Pubmed
- 3. William E. Erkonen, Wilbur L. Smith. Radiology 101. (2005) ISBN: 9780781751988 - Google Books
- 4. Zoran L. Barbaric. Principles of Genitourinary Radiology. (1991) ISBN: 9780865773479 - Google Books
- 5. Eid S, Iwanaga J, Loukas M, Oskouian R, Tubbs R. Pelvic Kidney: A Review of the Literature. Cureus. 2018;10(6):e2775. doi:10.7759/cureus.2775 - Pubmed