Simple renal ectopia refers to a kidney thats located on the proper side but in an abnormal position. 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. Crossed renal ectopia is more common for the left kidney to be ectopically located on the right side. In this condition the ureter from the ectopic kidney. Ectopic kidney with malrotation and bilateral multiple. 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. When the kidney stays in the pelvis, it is called a pelvic kidney. The main arteries and the accessory ones are of equal caliber. The simple renal ectopia is further divided into pelvic, iliac, abdominal, and thoracic kidneys based on the location, among which thoracic kidney is the least common subtype. Ectopic kidney may be abdominal, lumbar or pelvic, based on its position in the retroperitoneum bauer sb. However, some individuals with this disorder may experience longterm urinary problems such as kidney stones, kidney infections, and varying degrees of urinary incontinence. The most common position is in the pelvis opposite the sacrum and below the aortic bifurcation.
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. Rodriguez faba and others published ectopia renal cruzada. Crossed unfused ectopia constitutes a very rare variant of ectopic kidneys, with an approximate incidence of 1. Simple ectopic kidney refers to a kidney thats located on the proper side but in an abnormal position. 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. Most crossed renal ectopias are associated with fusion and left to right crossover 3. The most frequent associated urological abnormality was vesicoureteral reflux vur. Pdf solitary crossed renal ectopia with vesicoureteral. We report a case of simple ectopia of the kidney in monozygotic twins. Two collecting systems remain, and two ureters enter each side of the bladder. To our knowledge, fewer than 10 cases with scre associated with vesicoureteral reflux vur have been reported so far. Scre is a very rare anomaly of the urinary tract 6.
If the kidney crosses to the other side of the body, it is called crossed renal ectopia. An ectopic kidney may cross over and can become fused with the other kidney crossed renal ectopia. Failure of the kidney to complete ascent can be due to an abnormality of the ureteral bud, metanephric blastema, genetic abnormalities, teratogenic causes or anomalous vasculature acting as a barrier to ascent. Original research article crossed renal ectopia without. Rarely crossed fused ectopia can present with a single ureter draining ipsilaterally into the bladder, but here we are presenting for the first time a rare case of right crossed fused ectopia, where a solitary ureter. Manejo del trauma renal en paciente con ectopia renal con fusion. Multiple renal arteries are the most common variant among ectopic cases, with an incidence rate of 2030%. The hypothesis of a genetic mechanism for renal dysmorphogenesis could be tested by banking autopsy tissue and analyzing the messenger ribonucleic acid. A bilateral crossed renal ectopia, b unilateral crossed renal ectopia.
Pielonefritis en ectopia renal cruzada y fusionada nefrologia. Horseshoe kidney, bifid renal pelvis, spider kidney, extra renal pelvis, congenital calyceal diverticulum. Is a complete urological evaluation necessary in all newborns. In this abnormality, both the kidneys are located on the same side most cases fused, figure 1 with. Pdf is a complete urological evaluation necessary in all. Ectopia renal cruzada con fusion y litiasis multiple, nefrectomia con. In most cases ectopic kidney is found in the pelvis minor, in 5% of cases in the thoracic cavity. Simple ectopia refers to aberrant location of kidneys on the ipsilateral sides, which is usually further subclassi. This congenital condition may be characterized as simple as when both kidneys are.
When a kidney crosses over, the two kidneys on the same side often grow together and become fused. Different methods have been proposed to categorize thoracic ectopic kidneys. Trunk artery proceeds cranially, originating in lumbar region. We hereby describe a rare case of an incidental finding of crossed unfused ectopic kidneys, in a 45yearold gentleman incidentally found to have a bladder lesion. Simple renal ectopia kidney, ureter and vesicoureteral junction are on the same side of the abdomen. More than 85% of these get fused resulting in crossed fused renal ectopia.
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. According to wein the renal anomalies have been classified into various types. Epidemiology the estimated incidence is around 1 out of births 1. Only the crossed fused renal ectopia c is the fusion anomaly constituting 90% of all crossed ectopias. Papillary renal carcinoma arising in an ectopic native. Is a complete urological evaluation necessary in all. Ectopia renal cruzada con fusion, reflujo vesicoureteral y rinon. The most frequent anomalies associated with crossed ectopia are imperforate anus 4%, skeletal abnormalities 4%, and septal cardiovascular defects3. 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. One kidney or both may have crossed the midline and may be located on the other side of the abdomen. May 08, 2007 renal ectopia re describes a kidney that lies outside the renal fossa. The database records of 60 consecutive neonatal cases of re diagnosed at the. No family history of congenital anomalies was reported.
Crossed renal ectopia with fusion in a pelvic inlet area. To evaluate if a complete urological screening is justified by potential urological anomalies in newborns or infants with asymptomatic renal ectopia re. Renal ectopia pelvic kidney remaining in the pelvis close to the common iliac artery, it is known as a pelvic kidney 34 renal ectopia pelvic kidney 35 horseshoe kidney sometimes the kidneys are pushed so close together during their passage through the arterial fork that the lower poles fuse, forming a horseshoe kidney 36. All renal ectopias were located lower than usual site,four belongs to pelvic type figures 2c, 3b,two lumbar figure6 b and one iliac type. An ectopic kidney may remain in the pelvis, near the bladder pelvic kidney. This chapter is dedicated to the main renal anomalies detectable by ultrasound.
Crossed renal ectopia kidney lies on the opposite side to normal, but the ureter crosses the midline. 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. Kidney displacement does not give any clinical symptoms in the majority of patients, sometimes it may. The reported incidence of simple renal ectopia is 1. Martinezrodriguez and others published ectopia renal. This congenital condition may be characterized as simple. Females vwsicae a clitoris divided in two halves and may have two vaginal openings. In the other system, mc donald and mc clellanin in 1957 explained four types of crossed renal. Bilateral triple renal arteries were also revealed. Different imaging modalities in a clinical case of cross. The unique blood supply of his kidneys has also been described. It results from the kidney failing to ascend from its origin in the true pelvis or from a superiorly ascended kidney located in the thorax. Papillary renal carcinoma arising in an ectopic native kidney.
Abnormalities in shape and position a ectopic kidney or renal ectopia is defined as an atypically placed kidney due to faulty migration from the fetal pelvis during embryologic development meizner i, yitzhak m, levi a, et al. Pdf the incidence of associated urological abnormalities in. Luis jose orbegosocelis hospital nacional edgardo rebagliati martins. Right renal ectopia with malrotation was seen on a ct angiography in a 64yearold male patient. Crossed renal ectopia is a condition in which the kidney is located on the opposite side of its ureter entering the bladder. The occurrence of an associated anomaly in crossed renal ectopia, excluding solitary renal ectopia is low 16. These cases are distinguished by a relative lack of symptoms, in association with a large abdominal mass, preserva tion of normal renal function despite extreme dis placement, and the ability of intraabdominal. Anomalies of the lower urinary tract will be addressed in a separate chapter. Since these pathologies are frequently asymptomatic, the diagnosis is most commonly made after a routine imaging studies due to other causes or when recurrent uti or urinary obstruction are associated.
Ectopic kidney describes a kidney that is not located in its usual position. Renal ectopia is divided into simple or crossed forms 3. The incidence of renal ectopia of our study was higher than those stated earlier and more in males. Ectopic kidney, renal ectopia, causes, symptoms, diagnosis. Nov 24, 2020 background crossed fused renal ectopia is a rare congenital anomaly where both the kidneys are fused and situated on one side and drain bilaterally into the urinary bladder. Crossed renal ectopia refers to a kidney that has crossed from its side, to the other side. Since these pathologies are frequently asymptomatic, the diagnosis is most commonly madeafter a routine imaging studies due to other causes or when recurrent uti or urinary obstruction are associated. Thoracic kidneys are the least common subtype and only. Horseshoe kidney, lshaped kidney, cake kidney and sigmoid kidney are four subtypes of fusion anomalies which are fused medially 2. Crossed renal ectopia is the second most common renal fusion anomaly after horseshoe kidney, with an incidence of 1 in 1,000. A complete urological evaluation is necessary in newborns with c. Crossed fused renal ectopia radiology reference article. Simple ectopia refers to the abnormal kidney location on the same side.
This renal anomaly occurs during fetal development, approximately in the first. 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. Crossed renal ectopia with fusion in a female feline. Re for the high incidence of associated urological anomalies, of which vur is the most frequent. Note that in all these types the ureter is crossing the midline. Crossed complete fused left to right renal ectopia with. Crossed fused renal ectopia refers to an anomaly where the kidneys are fused and located on the same side of the midline. Both kidneys are located on the same side of the body.
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