Right Renal Enlargements Causing Alterations in the Descending Duodenum

For some time the senior author has been aware that many radiologists and clinicians in the allied fields of urology and gastroenterology do not realize that enlargement of the right kidney may produce deformity, displacement, or distortion of the descending duodenum. This fact is emphasized by the paucity of reports of such effects in the radiological literature and the failure of the major textbooks of roentgen diagnosis, gastroenterology, and urology to demonstrate them. With the excellent methods now available for direct investigation of the upper urinary tract, it might seem superfluous to attempt to diagnose right renal enlargement from a gastrointestinal series. On the other hand, it should be recalled that many persons with renal disease present themselves with symptoms which seem to arise from the digestive tract (1). For a variety of reasons an enlarged right kidney may not be palpable on physical examination and may thus be overlooked. In such an event a careful investigation directed toward th...