Teaching Case

Three month history of pain in the area of apendix after physical training. Patient has ultrasonography investigation. Right kidney wasn’t found. Intravenous pyelogram showed normal left kidney, right kidney was not discovered. Retrograde pyelogram revealed widened kidney at the level of L5-S1 vertebra and short ureter.

Kidneys which fail to ascend to their normal position are known as Ectopic kidneys. The most common form of ectopic kidney is the pelvic kidney.Since the kidneys are not in their normal position, their blood supply is also not the same as it would be in a normal kidney. Ectopic kidneys take their blood supply from the vessels closest to them at the end of their limited ascent. Such kidneys often maintain their fetal blood supply from the iliac vessels or the distal aorta. A solitary pelvic kidney is often associated with complications such as hydronephrosis and pelviureteric junction obstruction. If both kidneys lie on the same side of the abdomen they may be fused and vesicoureteral reflux is the most frequent problem. In principle, an asymptomatic ectopic kidney needs no special care. Recurrent infections, kidney stones or outflow obstruction are managed as in an orthotopic kidney. Accidental removal of such a kidney appears to occur when a surgeon mistakes it as a pelvic tumor. of A solitary pelvic kidney is often associated with complications such as hydronephrosis and pelviureteric junction obstruction. If both kidneys lie on the same side of the abdomen they may be fused and vesicoureteral reflux is the most frequent problem. In principle, an asymptomatic ectopic kidney needs no special care. Recurrent infections, kidney stones or outflow obstruction are managed as in an orthotopic kidney. Accidental removal such a kidney appears to occur when a surgeon mistakes it as a pelvic tumor.