Crossed fused renal ectopia and duplicated IVC

Case contributed by Dr Rozanne Visvalingam

Presentation

Blunt trauma to right upper quadrant with free fluid seen in pelvis on FAST scan in emergency department.

Patient Data

Age: 25 years
Gender: Male

Incidental findings of:

  • crossed fused renal ectopia with malrotated left kidney lying centrally and fused to lower pole of malrotated right kidney
  • duplicated inferior vena cava

Small amount of free fluid adjacent to tip of right hepatic lobe as well as in the pelvis, however no other signs of abdominal organ trauma or bony fracture noted.

Annotated image

Crossed fused renal ectopia and duplicated IVC marked.

Case Discussion

Crossed renal ectopy is a term used to describe kidneys that cross the midline and occur when the kidney fails to ascend to the retroperitoneal fossa. When they are fused to the contralateral kidney, this is known as crossed fused renal ectopy (seen in this case). The majority are asymptomatic and diagnosed incidentally however they can be associated with urinary tract infection, obstruction, renal calculi and vesicoureteral reflux. 

Duplication of the inferior vena cava is another anatomical variant and can be associated with renal ectopy. It is important to identify prior to vascular graft or IVC filter insertion.

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