Renal pyelic fusion with crossed solitary ureter: Case report and review of literature

Enganti, Bhavatej; Chitekela, Nookinaidu; Nallabothula, Anil Kumar; Lakshmi, Vijaya; Dandu, Rambabu Satya; Samavedi, Srinivas; Srinivasan, S.

doi:10.1111/iju.12102

Cited by 3 publications

(3 citation statements)

References 8 publications

(8 reference statements)

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“…This case represented a surgical hallmark and surprise in our records for many years. However, the suggestion of an underlying pyelic fusion is plausible after reporting of two similar cases in the literature by Enganti et al [5] and Bhat et al [6]which encouraged me to report this unique case which occurred many years ago. The similarity to these cases was in regard to the position and location of the kidneys.…”

Section: Discussionmentioning

confidence: 94%

“…The latters may occur, also, with crossed ectopic kidneys [3] or other extremely rare fusion anomalies [4]. However, pyelic fusion anomaly in non-fused orthotopic kidneys is exceedingly rare and hardly detectable in the literature [5,6]. Previously unreported anatomical anomalies may predispose to major surgical complications like what happened in the following case.…”

Section: Introductionmentioning

confidence: 82%

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Contralateral Perinephric Urinoma Complicated Retrocaval Ureter Repair: A Surgical Trap of Pyelic Fusion Anomaly

2017

IJCRR

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Aim: To present a case of pyelic fusion anomaly with orthotopic kidneys which is extremely rare. For maximum and only, it was reported twice in the literature. Its diagnosis may be unpredictable and it may predispose to major surgical complications.Case Report: An 8-year-old child was diagnosed to have a retrocaval ureter which was repaired through a flank incision. A striking finding of a cut and retracted tubular structure was noted during ureteral dissection. Postoperative contralateral perinephricurinoma developed and drained percutaneously. Then, two surgical explorations were done on the left kidney without detection of a cause for urinary extravasation. The left ureter was atretic during explorations. Kidney autotransplantation and ileal reconstructions seemed difficult solutions and nephrectomy was the final step.Discussion: Pyelic fusion anomaly was reported, mainly, in association to renal fusion anomalies like horseshoe and crossed ectopic kidneys. However, it is the first time to report a case of retrocaval ureter in association to pyelic fusion and normallylocated and positioned kidneys. Contralateral urinoma after repair of a retrocaval ureter was a striking complication referred to an underlying crossing left-to-right anomalous pathway. This case represented a surgical trap, because it is an extremely rare and unpredictable association of renal anomalies. Conclusion:Pyelic fusion with orthotopic well-positioned kidneys is an extremely rare renal anomaly. Its association to retrocaval ureter makes it extremely unpredictable, especially, when it is undiagnosed preoperatively.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 82%

Contralateral Perinephric Urinoma Complicated Retrocaval Ureter Repair: A Surgical Trap of Pyelic Fusion Anomaly

2017

IJCRR

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“…There are only a few case reports of renal pyelic fusion and most are in horseshoe kidneys where the two fused pelves were drained by a single ureter. [ 1 2 3 4 ] Most of these cases were associated with other congenital anomalies such as vertebral defects, vesico ureteric reflux, anorectal malformation, etc., Our patient did not have any other congenital anomaly. A previously reported case had pelvic fusion with the dilated left pelvicalyceal system draining into the common pelvis through an obstructed calyx in the isthmus of the horseshoe kidney.…”

Section: Discussionmentioning

confidence: 99%