Presentation
Right sided abdominal pain radiating to the back.
Patient Data
The right kidney appears enlarged.
The left kidney is absent from the left renal fossa.
A notch is seen posteriorly.
Normal liver, spleen and pancreas are normal.
The urinary bladder and prostate are normal.
Normal post void volume.
The left renal fossa contains small bowel loops only. The left kidney is seen fused to the lower pole of the right kidney.
The left renal artery and vein are seen arising from and draining into the right side of the abdominal aorta and inferior venacava respectively.
The left ureter is seen crossing over from right to left at the level of the L5 vertebra with normal position of the vesicoureteric junction.
No renal, ureteric or urinary bladder calculi seen. No renal mass or perinephric fat stranding is seen.
Normal corticomedullary differentiation and excretion of both kidneys ruling out pyelonephritis.
No hydroureteronephrosis.
Well distended urinary bladder with normal wall thickness and no focal mass seen.
Normal liver, spleen, acalculous gallbladder, appendix and bowel.
Case Discussion
Classic features of crossed fused renal ectopia, an incidental finding in this case and not attributing to the abdominal pain this patient was experiencing.
The left kidney is more commonly seen partially (upper pole only) fused with the lower pole of the right kidney, as in this case.
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