Presentation
Routine antenatal screening
Patient Data
Both kidneys are identified by their ectatic pelvises (pyelectasis), reaching 5 mm in AP diameter. The right renal pelvis is normal at its anatomical location.
The left kidney is not identified at the renal fossa and the left renal pelvis is located at the pelvis.
The urinary bladder is empty at the time of examination.
Fetal pyelectasis is still noted. The left kidney is clearly shown behind the filled urinary bladder. The right kidney is at its normal anatomical location.
Case Discussion
At the initial scan, the renal parenchyma is echogenic and couldn't be distinguished from surrounding bowel or organs. They were identified by the physiological pyelectasis at this gestational age. The urinary bladder was empty and the fluid-filled structure in the pelvis corresponds to the shape of pelvicalyceal system, and so ectopic pelvic left kidney was suspected.
Follow up after 2 weeks was recommended, as the renal parenchyma attained a little hypoechoic texture and both kidneys were identified. Fetal pyelectasis was also still noted and the scan clearly shows an ectopic left kidney behind the distended fetal urinary bladder.
This case shows the importance of trying to identify the kidneys early, and the friendly role of physiological fetal pyelectasis in the early diagnosis of abnormal renal position.
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