Horseshoe kidney and obstructive ureteral stone

Case contributed by Vitalii Rogalskyi
Diagnosis certain

Presentation

Non-specific flank pain.

Patient Data

Age: 60 years
Gender: Female

CT of the abdomen demonstrates complete fusion of lower poles of both kidney (horseshoe kidney) with marked left hydronephrosis and severe renal parenchymal thinning due to a ureteric calculus.

On the right the renal parenchyma is normal, the urinary collecting system is not dilated.

Annotated image

Horseshoe kidney with left severe hydronephrosis (blue arrow). Left ureteric calculi (red arrow). 

Case Discussion

Horseshoe kidney is the most common type of renal fusion anomaly. But in our case this condition was complicated by left ureteric calculi which caused gross dilatation of the renal pelvis, calyces and marked parenchymal atrophy.  It is severe hydronephrosis of left kidney (grade 4).

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