Pyelonephritis in a solitary kidney

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Abdominal pain and fever.

Patient Data

Age: 13 years
Gender: Female

Solitary enlarged left kidney. There is a focal wedge-shaped area of cortical hypoattenuation in the left interpolar region. Surrounding fat stranding and enlarged left para-aortic lymph nodes. There is a tiny right renal bud seen but a right ureter is present. Hepatic flexure fills the renal bed. No other genitourinary tract anomaly identified. 

Case Discussion

Renal agenesis is not uncommon, with an incidence estimated at 1 in 1000. There are many associations of renal agenesis and these should be sought out on imaging studies. 

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