Presentation
Likely pyelonephritis. Autotransplant of kidney 25 years ago. Acute right iliac fossa pain. To assess renal anatomy for any acute abnormalities.
Patient Data
Pacemaker leads partially imaged.
Liver, spleen, pancreas, adrenals unremarkable.
Orthotopic left kidney with ill-defined low densities in the upper and lower poles with perinephric stranding may represent pyelonephritis. No evidence of renal abscess or fluid collections. Nonobstructed pelvic right renal autotransplant with a small cortical cyst.
Florid sigmoid diverticulosis with associated muscle hypertrophy, no acute diverticulitis. Remainder of non prepared large bowel is unremarkable. No concerning findings of the non prepared small bowel which is generally decompressed with unremarkable terminal ileum, appendix not seen, may be surgically absent.
Postmenopausal uterus and adnexa are atrophic.
No nodal enlargement under the diaphragm.
Left total hip replacement. Previous fracture through the inferior left pubic ramus (best seen on bone windows - not shown here). No suspicious bone lesions. No vertebral compression fractures.
Opinion:
Acute pyelonephritis of left kidney without evidence of renal abscess.
Autotransplant right kidney in pelvis is unremarkable.
Case Discussion
Renal autotransplant is an infrequently performed surgical procedure in which a patient's own kidney is moved to a different anatomical location, often to improve symptoms. It may be that the native anatomical relationship between the kidney and the ureter was resulting in symptoms which could be relieved by repositioning the kidney.
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