Horseshoe kidney with ureteral stone

Case contributed by Dr Matt A. Morgan

Presentation

Colicky abdominal pain, radiating to the lumbar spine.

Patient Data

Age: 45
Gender: Female
Modality: CT

Horseshoe kidney with a 6 mm stone at the right ureterovesicular junction (UVJ). There is dilatation of the upstream collection system with stranding and a small amount of free fluid anterior to the right renal pelvis and proximal ureter, compatible with rupture and urine leak into the peritoneal space.

Left-sided collecting system is not dilated.

The appendix is normal.

Case Discussion

Persons with horseshoe kidneys are at higher risk for renal calculi than the average population (~20% lifetime risk). Because of ectopic exit of the ureters from the horseshoe kidney, the increased risk of stones has been thought to be due to urine stasis rather than abnormalities of the renal parenchyma. Some think that a combination of relative urinary stasis and metabolic abnormalities in the horseshoe kidney are required for stone formation.

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Case Information

rID: 39812
Case created: 21st Sep 2015
Last edited: 16th Aug 2016
System: Urogenital
Inclusion in quiz mode: Included

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