|Renal scan image demonstrates cross-fused renal ectopia. |
Image courtesy of RadsWiki
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. ; Associate Editor(s)-in-Chief: : Cafer Zorkun M.D., PhD.
Synonyms and keywords: Ectopic kidney
Renal ectopia is defined as an atypically placed kidney due to faulty migration from the fetal pelvis during embryologic development. Ectopic kidney may be abdominal, lumbar or pelvic, based on its position in the retroperitoneum. It can be placed either ipsilaterally or contralaterally, when it is called crossed renal ectopia.
Differentiating Renal ectopia from other Diseases
Epidemiology and Demographics
Natural History, Complications and Prognosis
Diagnostic Study of Choice | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X Ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies
Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies
A 28–year-old male presented with recurrent pain in his lower left abdomen present for one month and an episode of hematuria 3 days earlier, accompanied by an attack of acute pain lasting for 3–4 hours. He gave a history of passing 2 small (about 5 mm each) calculi in his urine after the occurrence of hematuria, following which pain decreased in intensity. No history of fever was present.
Investigations and Findings :
- Routine blood tests were normal except for erythrocyte sedimentation rate which was slightly raised (38 mm/hr, Westergren method).
- Urine was sterile and serum creatinine and urea were within normal limits.
- The kidneys/ureter/bladder x-ray was unremarkable.
- An emergency ultrasound scan of the abdomen was reported as non-visualization of the left kidney in the left renal region, or elsewhere in the abdomen.
- During scan of the urinary bladder which was normal in outline a jet of urine was seen emerging from the left uretero-vesical junction which was confirmed on color Doppler examination. These sonographic findings led to the impression of an ectopically located left kidney.
- Subsequently, an IVP (intravenous pyelogram) was requested. It revealed that the left kidney was not located in its normal anatomical position and was instead found at the level of L4, L5 and S1 vertebrae, slightly to the left of the midline
- It was smaller compared to the right kidney, measuring 10 cm vertically, 7 cm transversally, and 3.5 cm in thickness (right kidney measured 14×10×4.5 cm). This ectopic kidney was slightly malrotated with its pelvis oriented anteromedially. The long axis passed inferiomedially. It showed normal excretion on IVP.
- The right kidney was normal in size, site and function. No calculus or hydronephrosis was seen. Both ureters were normal with contrast opacification and were opening into the bladder. The left ureter was, however, shorter in its course. The urinary bladder showed normal contrast opacification and on emptying, no significant residual urine was seen.
As the patient did not present with any other complaint, he was discharged with the advice of follow-up ultrasound scans and to report back in case of similar complaints in future.