Ectopia renal cruzada con fusión, reflujo vesicoureteral y riñón ectópico afuncional:: informe de un caso

Se presenta el caso de un nino cuyo ultrasonido materno-fetal de la semana 20 de la gestacion no detecto alteraciones, pero el de la semana 23,6 mostro un rinon pelvico derecho. A los 22 dias de nacido el ultrasonido renal mostro un rinon derecho de tamano y posicion normal y dilatacion pelvica moderada, e inmediatamente por debajo del polo inferior de este, un bolson hidronefrotico que parecia corresponder a una ectopia renal cruzada con hidronefrosis grave. El padre padecio reflujo vesicoureteral derecho que desaparecio espontaneamente. A pesar de la profilaxis con cefalexina, hubo una infeccion urinaria que se trato satisfactoriamente con ceftriaxona. Investigaciones ultrasonograficas y radioisotopicas arrojaron la existencia de una anomalia congenita dada por dilatacion pelvica no obstructiva del rinon derecho, ectopia renal cruzada con fusion del rinon izquierdo afuncional y reflujo vesicoureteral bilateral, de grado II del rinon derecho y de grado V del izquierdo ectopico cruzado. A los 11 meses de edad se le realizo una lumbotomia y se comprobo la fusion del bolson hidronefrotico con el polo inferior del rinon derecho. Se reseco el bolson y se realizo una ligadura baja del ureter This is the case of a child whose maternal-fetus ultrasound (US) at twenty weeks pregnancy not detected alterations, but at the 23, 6 weeks it showed the presence of a right pelvic kidney. At twenty two days the renal US showed a right kidney with a normal size and location as well as a moderate pelvic dilation and immediately beneath its lower pole a hydronephrosis big sac in correspondence with a crossed renal ectopia with severe hydronephrosis. His father had right vesiculorectal reflux disappeared spontaneously. Despite the prophylaxis with Cephalexin there was a urinary infection adequately treated with Cephtriaxone. Ultrasonography and radioisotope researches demonstrated the presence of a congenital anomaly due to the no-obstructive pelvic dilation or right kidney, crossed renal ectopia with fusion of dysfunctional left kidney and II degree bilateral vesicoureteral reflux from right kidney and of V degree from the crossed ectopic left kidney. At eleven months life he undergoes a lumbotomy and the hydronephrosis big sac was fused with lower pole of the right kidney. This big sac was resected and a low ureter ligature was carried out