Major Venous Anomalies Are Frequently Associated With Horseshoe Kidneys - Value of Multidetector Computed Tomography -
Tamaki IchikawaShuichi KawadaJun KoizumiJun EndoMisako IinoToshiro TerachiYukio UsuiToshiya NishibeAlan DardikYutaka Imai
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Abstract:
Background: Several cases of horseshoe kidney with anomalous inferior vena cava (IVC) have been described, but there have been no reports of the incidence and variation of anomalous IVC in patients with horseshoe kidneys detected using multidetector row computed tomography (MDCT). Methods and Results: 105 patients with horseshoe kidneys were evaluated with MDCT and a variety of venous anomalies were identified in 30 patients (28.6%). Anatomical variations of the renal vein were identified in 24 patients (22.9%), which was no higher than the reported incidence in the general population. However, variations of the IVC were identified in 6 patients (5.7%), which was a higher incidence than expected to be found in the general population: 1 pre-isthmic IVC with retrocaval ureter, 2 double IVCs posterior to the horseshoe kidney, 2 left IVCs posterior to the horseshoe kidney, and 1 azygos continuation of the IVC. Conclusions: Horseshoe kidneys are frequently found in patients with other venous, and particularly IVC, anomalies, which should be evaluated using MDCT as part of treatment planning. (Circ J 2011; 75: 2872-2877)Keywords:
Multidetector computed tomography
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Horseshoe kidneys are the commonest renal anomalies. It is more prone to certain complications, including recurrent infections, renal stones, ureteropelvic junction obstruction, vesicoureteric reflux, and even renal malignancy. In a horseshoe kidney the ureter exits the renal pelvis ventrally and more superiorly, and the longitudinal renal axis converges medially. This has important implications in relation to the management of stones in horseshoe kidneys. This chapter discusses the management of renal calculi in the horseshoe kidney.
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We report a case of supernumerary kidney consisting of 4 renal moieties and including a horseshoe kidney. A 40-year-old woman presented complaining of intermittent vague abdominal pain and heaviness for a few years. Ultrasonography of the urinary tract revealed 2 kidneys on the left side and horseshoe kidneys located distal to them. The right horseshoe kidney was of small size. Further imaging revealed 4 renal moieties. Three moieties were on the left side and the other was attached to the most distal moiety on the left, forming a horseshoe kidney.
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[Objective] To assess the safety and feasibility of minimally invasive percutaneous nephrolithotomy (mPCNL) in treating calculi within horseshoe kidney. [Methods] We retrospectively investigated the outcome of 8 patient of calculi within horseshoe kidneys who were treated with minimally invasive percutaneous nephroli-thomy. [Results] Of 8 cases,calculi within bilaterall horseshoe kidneys was 3. Access to the horseshoe kidneys was subcostal in 8 and supracostal in 3, A single tract was used in 9 kindeys, and two tracts were created in the remaining 2, renal access was obtained through upper calyx in 5 cases, a middle calyx in 4, and upper+middle calices in 2 cases. 73% (8/11) were rendered stone free at 1 session. Average operation time was 150 munites, and the mean hospital stay was 10 days. No major complications were seen. Follow up was 3 to 21 months, no stone recurrence was noted. [Conclusions] Minimal-ly invasive percutaneous nephrolithotomy is a safe and effective method of stone re-moval in patients with calculi in horseshoe kidneys.
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In a review of the literature, the association nephroblastoma-horseshoe kidneys has been demonstrated in 34 patients. Radiologic signs of horseshoe kidney may be difficult to evaluate when a large mass is present. Treatment of Wilms' tumor in horseshoe kidneys does not differ, on principle, from that of Wilms' tumor occurring in the normally separated kidneys.
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No AccessJournal of Urology1 May 1981Horseshoe Kidney and Urolithiasis William P. Evans and Martin I. Resnick William P. EvansWilliam P. Evans and Martin I. ResnickMartin I. Resnick View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)55139-3AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Patients with horseshoe kidney and associated urinary stone disease were reviewed. There were 8 patients evaluated and the data indicate that similar metabolic parameters governing stone disease in anatomically normal kidneys also are operative in the horseshoe kidney. This fact must be recognized in the evaluation of these patients so that metabolic disorders can be identified and treated properly. © 1981 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byBlanc T, Koulouris E, Botto N, Paye-Jaouen A and El-Ghoneimi A (2013) Laparoscopic Pyeloplasty in Children with Horseshoe KidneyJournal of Urology, VOL. 191, NO. 4, (1097-1103), Online publication date: 1-Apr-2014.RAJ G, AUGE B, WEIZER A, DENSTEDT J, WATTERSON J, BEIKO D, ASSIMOS D and PREMINGER G (2018) Percutaneous Management of Calculi Within Horseshoe KidneysJournal of Urology, VOL. 170, NO. 1, (48-51), Online publication date: 1-Jul-2003.Yohannes P and Smith A (2018) The Endourological Management of Complications Associated with Horseshoe KidneyJournal of Urology, VOL. 168, NO. 1, (5-8), Online publication date: 1-Jul-2002.Jones D, Wickham J and Kellett M (2018) Percutaneous Nephrolithotomy for Calculi in Horseshoe KidneysJournal of Urology, VOL. 145, NO. 3, (481-483), Online publication date: 1-Mar-1991.Smith J, Van Arsdalen K, Hanno P and Pollack H (2018) Extracorporeal Shock Wave Lithotripsy Treatment of Calculi in Horseshoe KidneysJournal of Urology, VOL. 142, NO. 3, (683-686), Online publication date: 1-Sep-1989. Volume 125Issue 5May 1981Page: 620-621 Advertisement Copyright & Permissions© 1981 by The American Urological Association Education and Research, Inc.MetricsAuthor Information William P. Evans More articles by this author Martin I. Resnick More articles by this author Expand All Advertisement PDF downloadLoading ...
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The Horseshoe kidney is not uncommon entity with an incidence of 0.25% of general population with increased association of genitourinary anomalies. Horseshoe kidney with single ureter is extremely rare. We report a case of a patient with a Horseshoe kidney with a single ureter with stone that was diagnosed incidentally. Bangladesh J. Urol. 2021; 24(1): 110-111
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Two cases of nephroblastoma occurring in a horseshoe kidney are reported, and 32 cases from the literature are reviewed. The radiologic signs of horseshoe kidney may be difficult to evaluate with excretory urography when the mass is large. Rotational abnormalities of the opposite kidney that is not involved by tumor should suggest the possibility of an associated horseshoe kidney. Real-time ultrasonography and computed tomography are helpful in identifying the isthmus of the horseshoe kidney. Aortography confirms the presence of the horseshoe kidney and demonstrates the arterial supply to the isthmus and the tumor. Radionuclide scans demonstrate the isthmus when the tumor arises from an upper pole, but may not be diagnostic if the tumor arises from the isthmus.
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No AccessJournal of Urology1 Jul 1938Surgery of the Horseshoe Kidney with a Post-Aortic Isthmus: Report of Two Cases of Horseshoe Kidney W. Dabney Jarman W. Dabney JarmanW. Dabney Jarman More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)71735-1AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1938 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byAnson B, Pick J and Cauldwell E (2018) The Anatomy of Commoner Renal Anomalies: Ectopic and Horseshoe KidneysJournal of Urology, VOL. 47, NO. 2, (112-132), Online publication date: 1-Feb-1942. Volume 40Issue 1July 1938Page: 1-9 Advertisement Copyright & Permissions© 1938 by The American Urological Association Education and Research, Inc.MetricsAuthor Information W. Dabney Jarman More articles by this author Expand All Advertisement PDF downloadLoading ...
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Sonography can be used to detect horseshoe kidneys. Sonographic findings for horseshoe kidney commonly include an isthmus connection occurring anterior to the aorta and just inferior to the inferior mesenteric artery. This anomaly can occur with or without complications. Each kidney is associated with its separate collecting system, leading to increased risk for complications. This case study describes the importance of identifying a horseshoe kidney, isthmus, and blood supply to ensure prompt intervention if needed. A case report of a horseshoe kidney with a solid mass, in the isthmus, is provided.
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