Horseshoe kidney with bilateral pelvi-ureteric junction obstructions

Case contributed by Dr Amr Farouk

Presentation

35 years old patient with diagnosed renal abnormalities for preoperative preparation.

Patient Data

Age: 35 years old
Gender: Male

The two kidneys lower poles are fused across the midline with an isthmus of renal parenchymal tissue at L3 vertebral body level with rendered ascent by the inferior mesenteric artery.

The lower renal poles are closest to midline with anterior rotation of the pelvicalyceal systems facing anteriorly.

Bilateral dependent non-obstructing lower calcyeal radio-dense calculi are seen more numerable on the right side, the largest measuring 7.5 mm in diameter.

Marked dilatation of the left renal pelvis and moderate dilatation of the right renal pelvis with collapsed both ureters are seen.

The right kidney show average parenchymal thickness showing normal parenchymal enhancement & excreted contrast promptly with opacification of the pelvicalyceal system at delayed phase (5 minutes acquisition) with patent right ureter evidenced by contrast seen at the distal right ureter at the 60 minutes delayed phase.

The left kidney show reduced parenchymal thickness with reduced parenchymal enhancement & non-opacification of the pelvicalyceal system at delayed phases (5, 10 & 60 minutes acquisition).

Smooth filling of the urinary bladder with no filling defects or diverticular outpouching.

Case Discussion

Horseshoe kidneys with bilateral pelvi-ureteric junction obstructions, bilateral hydronephrosis being marked on the left side and moderate on the right side with left renal parenchyma atrophic changes & bilateral non-obstructing dependent lower calyceal renal calculi.

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Case information

rID: 43045
Case created: 20th Feb 2016
Last edited: 6th Jun 2017
Inclusion in quiz mode: Included

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