A rare presentation of an ectopic kidney with pyelonephritis mimicking appendicitis

Abstract

Acute appendicitis is one of the top differential diagnoses of right lower quadrant pain in the emergency department. There are many other conditions that may mimic appendicitis such as diverticulitis, colitis and gynecological conditions. We report a rare diagnosis of a patient who presents with characteristic clinical and laboratory features of appendicitis with severe sepsis, but later showed acute pyelonephritis of a malrotated right ectopic kidney on computer tomography. An ectopic kidney is very rare with an incidence of 1 in 3000. It is usually asymptomatic, although it may also associate with obstruction, infection and urolithiasis. This case report raises the importance of early recognition of the correct diagnosis using imaging in appropriate clinical settings, and prompt antibiotic treatment can avoid unnecessary surgical intervention, preserve renal function and prevent a life-threatening catastrophe.

Malrotation of an iliac ectopic kidney with pyelo-ureteral duplication: An incidental three-in-one congenital anomaly

“…Even if there was no traumatic injury to the kidney, it is important to note that ectopic kidneys are more exposed to trauma because they are not protected by the ribs of the posterior thoracic wall [7] . Patients with ectopic kidneys are also prone to complications such as vesicoureteral reflux, urinary tract infections, kidney stones, all of which could be an opportunity to discover an ectopia [1] . Renal ectopias are most often located on the left side, which was the case for our patient [8] .…”

“…Renal ectopia is a rare birth anomaly with an incidence of 1 in 3000 [1] . Renal ectopia can occur in different parts of the body, such as in the abdomen, in the pelvis, in the iliac, or in the thorax [2] .…”

Acute appendicitis coexisting with acute pyelonephritis causing diagnostic dilemma: a case report

“…Renal colic and abdominal pain are the most common causes of emergency department applications [1]. Acute appendicitis is the most common diagnosis in patients presenting with right lower quadrant pain.…”

“…Acute appendicitis is the most common diagnosis in patients presenting with right lower quadrant pain. Diverticulitis, colitis, gynecological pathologies, and ureteral stones that mimic acute appendicitis should be kept in mind as differential diagnoses [1]. Renal colic is mostly related to ureteral stones, pyelonephritis with obstruction on the ureter, and rarely renal infarctions.…”

“…Imaging methods such as ultrasonography (USG) and computed tomography (CT) are frequently used for diagnosis in patients presenting with abdominal pain or renal colic [2,3]. The sensitivity and specificity of CT are 94% and 95%, respectively, in diagnosis of adults presenting with abdominal pain [1,2].…”