An unusual presentation of An unusual presentation of bilateral pelvic kidneybilateral pelvic kidney

Prakash.A. , Hussain.S.Gajdhar.M. , Sharma.D.B.

Department of surgery, NSCBMC, Jabalpur.

INTRODUCTIONINTRODUCTION

Renal ectopia a rare congenital anomaly (1:1000)

Most commonly ectopic kidney lie in the pelvis(1:3000)

Left sided anomaly more common

Bilateral ectopic pelvic kidney(1:10000)

CASE REPORTCASE REPORT

20 Year old female presented with- right lower abdominal pain since 6 mths- recurrent fever, vomiting, anorexia & amennorhoea since

2 mths

O/E : firm , tender right iliac fossa lump extending to hypogastrium

P/V : tender lump through right fornix

INVESTIGATIONSINVESTIGATIONS Routine hemogram :

chronic inflammatory response

Renal function test : Normal

X ray KUB : radio opaque density

in rt hemipelvis

INVESTIGATIONSINVESTIGATIONS

USG KUB : right pelvic multicystic kidney with septations & internal echoes

- E/O collection in right iliac fossa, ? Perforated appendix

Intravenous Urography

Lt kidney – normally functioning pelvic in position

Rt kidney – not visualised

INVESTIGATIONSINVESTIGATIONS

Contrast enhanced CT scan

- Bilateral ectopic (pelvic) kidneys

- Lt kidney – normally functioning

- Rt kidney – poorly functioning, calculi with

pyonephrosis with loss of perinephric fat

planes

MANAGEMENTMANAGEMENTRt nephrectomy done with rt Gibsons incision

DISCUSSIONDISCUSSION

Rt ectopic pelvic kidney with pyonephrosis

may mimic appendicular lump

Sonography – first investigation

Pre operative IVU – assesses renal function

CECT – Investigation of choice

Avoid injury to iliac vessels & opposite ureter

MESSAGEMESSAGE

In any case presenting with right lower

quadrant mass possibility of ectopic pelvic

kidney should always be kept in mind.