Horseshoe kidney with pelviureteric junction obstruction
Left loin pain
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The kidneys are fused at the lower poles anterior to the aorta and inferior to the inferior mesenteric artery compatible with a horseshoe kidney.
Severe left hydronephrosis with ballooning of the left renal pelvis and marked left renal cortical thinning.
The left kidney is significantly enlarged measuring about 22 cm.
The left ureter is not dilated.
No kidney stones. No right hydronephrosis.
No stones are seen along the course of the ureters.
The urinary bladder is empty.
Horseshoe kidney is the most common renal fusion anomaly, estimated to occur in 0.25% of the population.
It is more common in males, at a 2:1-ratio.
Horseshoe kidneys are frequently associated with other congenital anomalies and ureteropelvic junction obstruction.
The following factors may contribute to pelviureteric junction obstruction in horseshoe kidneys: anomalous vascular supply to the kidney, high insertion of the ureter into the renal pelvis, its abnormal course over the isthmus, and its intrinsic pathogenesis.