Intraoperative detection with a sigma complicated neoplasia is more infrequent and requires. He had multiple comorbidities and a rightsided crossed fused kidney supplied by two small renal arteries arising from the aaa. The anomalies presented are renal agenesis, renal development variants, autosomal recessive polycystic kidney disease, multicystic dysplastic kidney disease, autosomal dominant polycystic kidney disease, obstructive cystic dysplasia. To the best of our knowledge, only 35 cases of crossed renal ectopia involving calculi and 30 cases of cre associated with renal carcinoma have been reported to date patient concerns. Crossed fused renal ectopia is a rare congenital anomaly, and is mostly detected incidentally. The ureter of the lower kidney crosses the midline to enter the bladder on the contralateral side. Rodriguez faba and others published ectopia renal cruzada. No family history of congenital anomalies was reported. Anomalias congenitas del rinon y del tracto urinario pediatria integral. Eventration of the diaphragm with high renal ectopia. Pdf to report two cases of right crossed nonfused renal ectopia diagnosed in male patients about 30 years of age who arrived to emergency.
Pdf on jan 1, 2016, ramiro galvezvaldovinos published ectopia renal cruzada con fusion. Nephroureterectomy with bladder cuff excision was the treatment of choice. Nephroureterectomy of righttoleft crossed fused renal. A staged repair of crossed fused renal ectopia with complex. Original research article crossed renal ectopia without. Ectopia renal cruzada no fusionada con malformacion. Oct 14, 2020 mayerrokitanskykusterhauser syndrome with rare findings of inferior crossedfused renal ectopia and gartners duct cyst. Get started buy now acrobat pro dcs comprehensive pdf features show why its still the editor against which all others are judged. Ectopia renal cruzada con fusion, reflujo vesicoureteral y rinon. Percutaneous nephrolithotomy in renal anomalies of fusion. Pielonefritis en ectopia renal cruzada y fusionada nefrologia.
Crossed renal ectopia is a condition in which the kidney is located on the side contralateral to its ureteral insertion into the urinary bladder. Ectopic kidney is a congenital defect that results due to improper positioning of the kidney during fetal development. From 2002 to july 2007, 48 patients mean age, 28 years underwent pcnl for mean stone size of 39 mm. In this abnormality, both the kidneys are located on the same side most cases fused, figure 1 with. An ectopic kidney may remain in the pelvis, near the bladder pelvic kidney. We report an unusual case of nonfused crossed renal ectopia. Mar 31, 2021 crossed fused renal ectopia cfre is a type of renal anomaly where the kidneys are fused together and are located on one side of the vertebral column. Ectopic kidney, renal ectopia, causes, symptoms, diagnosis. A 45yearold man, during investigation for recurrent abdominal pain, was found to have an empty left renal fossa and right crossed renal ectopia with fusion on ultrasonography. Crossed renal ectopia cre is a rare congenital anomaly that is frequently associated with gastrointestinal, cardiovascular, genital and bone malformations. Is a complete urological evaluation necessary in all.
Renal ectopia occurs due to brief interference of kidney ascension by the failure of degeneration of fetal renal blood supply or lack of factors responsible for ureteral growth and elongation 2, 3. An ectopic kidney may cross over and can become fused with the other kidney crossed renal ectopia. Renal anomalies varied from mild malrotation to crossed renal ectopia without fusion. Crossed fused renal ectopia cfre is a type of renal anomaly where the kidneys are fused together and are located on one side of the vertebral column. An ectopic kidney, also known as renal ectopia, is a congenital renal anomaly characterised by the abnormal location of one or both of the kidneys.
It may remain undetected in the absence of abdominal pain or urinary infection. Crossed renal ectopia is a rare congenital anomaly usually associated with fused kidneys 90%. Abstractcrossed fused renal ectopia is a rare congenital anomaly, and is mostly detected incidentally. Pdfcreator is our free pdf converter that lets you convert files to pdf, merge pdf files, rearrange pdfs, and more. Pelvic renal ectopia, an incidental finding bmj case reports. The ectopic kidney may cross over to the contralateral side where it may fuse with the second kidney crossed renal ectopia. High renal ectopia and congenital diaphragmatic hernia. Common sheat ureteroneocystostomy ucn for a duplex kidney with closely spaced ureteral orifices. A 59yearold woman with diabetes presented to our hospital with abdominal pain. When the kidney stays in the pelvis, it is called a pelvic kidney. Crossed fused renal ectopia radiology reference article.
Multiple renal arteries are the most common variant among ectopic cases, with an incidence rate of 2030%. Crossed renal ectopia cre is a rare congenital anomaly consisting of the transposition of a kidney to the opposite side. Discussion the reported incidence of crossed renal ectopia is 1. Most cases are asymptomatic and remain undiagnosed. Ectopic acth syndrome, also known as smallcell carcinoma ectopic calcification, a pathologic deposition of calcium salts in tissues or bone growth in. As part of her evaluation, she underwent computed tomographic urography figures 1, 2, 3 and 4. If the kidney crosses to the other side of the body, it is called crossed renal ectopia. Gruber 3 in 1927 had collected from the literature 11 cases of partial or complete thoracic ectopia of the kidney observed exclusively in fetuses or stillborn children.
Crossed renal ectopia is more common for the left kidney to be ectopically located on the right side. Observations on renal ectopia and fusion in children. Renal dysplasia associated with ureteral ectopia and. Crossed renal ectopia with fusion is a very rare condition, and crossed ectopia without fusion is much rarer. Endovascular repair of an abdominal aortic aneurysm. The very length of the ureter precluded any but a congenital origin for the ectopia. Anomalies of the lower urinary tract will be addressed in a separate chapter. The 11yearold adolescent female patient was admitted with abdominal pain, anorexia, weight loss, and periumbilical mass. Here, we present the case of a 77yearold man with an abdominal aortic aneurysm associated with crossed fused renal ectopia and an ectopic renal artery arising directly from the aneurysm sac. Thoracic ectopic kidney is a rare anomaly, the rarest of all renal ectopia types 0. Polycystic kidney, ectopic kidney, bph and urethral stricture were. Ureteral ectopia medigoo health medical tests and free.
Fourteen patients had malrotated kidneys, 12 patients had bifid renal pelvis with complete or incomplete double ureter, 10 horseshoe kidneys, 8 hypo plastic kidneys, 3 with crossed fused ectopia, and 1 had pelvic kidney. We report 2 cases that illustrate these difficulties and show that a branch artery stenosis may be overlooked even by the gold standard method, renal angiography obesity is a risk factor for renal damage in native kidney disease and in renal transplant recipients. Horseshoe kidney is the most common renal fusion anomaly and is characterized by the presence of two. Nevertheless, the ectopic kidney s ureter crosses the midline to insert in its normal position in the bladder. This chapter is dedicated to the main renal anomalies detectable by ultrasound. Crossed fused ectopia of the kidneys kidney international. The fused kidney was carefully dissected until an area of demarcation emerged between. Crossed fused renal ectopia is a rare congenital anomaly of the urinary system where one kidney crosses over to opposite side and the parenchyma of the two kidneys fuse. This renal anomaly occurs during fetal development, approximately in the first. Two collecting systems remain, and two ureters enter each side of the bladder. Solitary crossed renal ectopia jama surgery jama network.
Crossed renal ectopia without fusion is a very rare anomaly sporadically reported in the literature. More than 85% of these get fused resulting in crossed fused renal ectopia. We describe the surgical management used to treat upper tract urothelial carcinoma in a 64yearold man with a righttoleft cfre. Most commonly, the kidney is located in a pelvic position, although iliac, abdominal, and thoracic locations have been reported. Hauser syndrome with rare findings of crossedfused renal ectopia and gartners duct cyst. Ureteropyelostomy or ureteroureterostomy for a duplex kidney and widely spaced ureteral orifices. An adult lady diagnosed as a case of ovarian carcinoma, found to have a mass in the left thoracic cavity. Ectopic kidneys usually are found in the pelvis, the iliac or low lumbar region.
Eventration of the diaphragm with high renal ectopia radiology. Most crossed renal ectopias are associated with fusion and left to right crossover 3. This document was created by unregistered version of word to pdf converter. The majority of pediatric patients are asymptomatic, but they often have. Crossed fused renal ectopia is a rare congenital anomaly in which the kidneys are fused and are located on the same side relative to midline. Epidemiology the estimated incidence is around 1 out of births 1. We have attempted to analyse such renal anomalies in.
Mayerrokitanskykusterhauser syndrome associated with fused. Most ectopias are congenital, but some may happen later in life examples. Ectopic kidney renal ectopia causes, symptoms, diagnosis. Urothelial carcinoma in a crossed fused renal ectopia cfre is an exceedingly rare clinical finding. The role of routine postnatal abdominal ultrasound for. Mayerrokitanskykusterhauser syndrome with rare findings of. The spectrum of renal ectopia ranges from a kidney that may have ascended too far cranially a thoracic kidney, to the more common, not completely ascended kidney, which comes to rest anywhere from the pelvis to the renal fossa fig. In the present case, there were no abnormalities andor alteration of the renal function. Crossed renal ectopia with fusion, vesicoureteral reflux and dysfunctional ectopic kidney a case report. The incidence of crossedfused renal ectopia on autopsy and live birth has been reported to be approximately 1. Create, sign, share, edit, convert, and export pdfs across desktop, mobile, and web. Different imaging modalities in a clinical case of cross.
Key method both of the kidneys are ectopic with the crossed ectopic right kidney lying superiorly and fused to the upper pole of the left kidney. If reflux into the ureteral ectopia is present, resection of distal ectopic ureter is necessary. Ninety percent of the crossed ectopic kidneys are fused 24. The imaging revealed the rare finding of crossed fused ectopia of the kidneys. Aug 20, 2016 crossed fused renal ectopia in the presence of abdominal aortic aneurysms aaas is a rare challenge to therapy. The second patient was a 24yearold woman who complained with abdominal pain with a duration of 1 day. Crossed renal ectopia with a fused supernumerary kidney. Crossed renal ectopia is the second most common renal fusion anomaly after horseshoe kidney, with an incidence of 1 in 1,000.
Renal fusion anomalies are common congenital anomalies of the urogenital tract and have their genesis in the early embryonic period. Renal ectopia or ectopic kidney is a developmental anomaly resulting from failure of the solid organ to migrate to its normal location within the retroperitoneal space. Although the initial clinical suspicion was a tumoral. Simple renal ectopia can be unilateral or bilateral and is due to the partial arrest of normal renal ascent or excessive ascent. Download our free pdfcreator and start converting your pdf files. This illustrations deals with one of the important renal anomalies, ectopic kidney. Chimneysnorkel endovascular aneurysm repair chevar enables the minimally invasive treatment of abdominal aortic aneurysm in anatomically challenging and highrisk surgical cases. They are classified into partial fusion anomalies e. One kidney or both may have crossed the midline and may be located on the other side of the abdomen. A 37yearold woman was referred to the chronic kidney disease clinic for frequent urinary tract infections since childhood.
A new subtype of crossed fused ectopia of the kidneys. After horseshoe kidney, crossed fused ectopia of the kidneys is the most frequent fusion abnormality of the urinary tract. Ruptura espontanea en fusion renal y pielica con sistema unico. The reported incidence of simple renal ectopia is 1. Other than the pelvis, cases of iliac and thoracic kidney have also been reported in the literature. Prenatal diagnosis consisted of pelvic kidney n 24, unilateral renal agenesis n, horseshoe kidney n 2 and crossed fused renal ectopia n 1. Cross fused renal ectopia is a rare anomaly with the estimated incidence is around 1 out of births 4. In many cases, the two kidneys are fused together, yet retain their own vessels and ureters. Crossed renal ectopia is a rare pathology that is often asymptomatic. An ectopic kidney is one that is congenitally displaced and has never occupied a normal position. This highly flexible pdf converter is easy to use and aligns with your requirements. Ocular manifestations varied from complete eye coloboma, coloboma of the optic nerve, ptosis, and duane anomaly.
We have attempted to analyse such renal anomalies in a large series of patients. The simultaneous presence of renal aplasiadysplasia, ureteral ectopia and seminal vesicle cyst represents an exceptionally rare malformation. The embryogenesis of this entity is discussed, along with consideration of the associated multiple congenital anomalies. Jul 12, 2011 the ectopic kidney is one which lies outside the normal renal fossa at the level of the 1 st to 3 rd lumbar vertebrae and is usually in the pelvis but may rarely be in the posterior thorax. Review of the literature since the appearance of wilmers 1 excellent and comprehensive article in 1938 shows that this condition has been reported almost exclusively in the urologic literature, while only a very occasional report has appeared in the pediatric journals. Complete blood count and urinalysis were normal and serum creatinine was 0. The first case was reported by dominicus panarolus in 1654, and today, it has an estimated prevalence of about 1 in live births with a 3. On the basis of abdominal ultrasonography, we suspected a solitary kidney both in the two. An ectopic pelvic kidney is one that is fixed within the bony pelvis or across the spine and derives its blood supply from the adjoining large vessels, such as the iliac arteries. Crossed fused renal ectopia refers to an anomaly where the kidneys are fused and located on the same side of the midline. A case of diaphragmatic eventration associated with high renal ectopia, verified by autopsy, is reported for the following reasons.
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