Horseshoe kidney and extrarenal pelvis

Case contributed by Bahman Rasuli
Diagnosis certain


Vague flank and abdominal pain on the right side for several years.

Patient Data

Age: 50 years
Gender: Male

IVU findings:

  • both kidneys appear rotated and both lower poles are directed medially toward the spine

  • normally functioning of the left kidney

  • severe right hydronephrosis despite having a normal calyceal system

  • Presence of contrast material within the right kidney pelvicalyceal system after 6 hours without evidence of obvious excretion and ureter opacification in its lower two third portion

Case Discussion

IVU findings are compatible with a horseshoe kidney and dilatation of the right kidney pelvic region in spite of having a normal shape calyceal system. There were two differential diagnoses for this IVU image, Right kidney UPJ obstruction and right kidney extra-renal pelvic.

For a better assessment, a diuretic renal scan by Tc was done and revealed "retention of activity in the dilated right pelvicalyceal system drains after lasix injection and post-voiding" in favor of non-obstructive right-sided hydronephrosis.

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