Malrotated Ectopic Kidney – A Case Report and Review of Literature

Abstract

The term is derived from the Greek words ek ("out") and topos ("place") and literally means "out of place." Ectopic kidney is a congenital defect where kidney is in unusual anatomical position. An ectopic kidney is often associated with an increased incidence of stone formation as a result of stasis caused by the altered geometry of urinary drainage [1]. Factors which interfere with development such as the ureteric bud not meeting with the nephrogenicblastema for normal nephrogenisis or metanephric maternal disease, may result in abnormal migration of the kidney resulting in renal ectopia [2, 3]. Diseases in ectopic kidney may present diagnostic problems and unwary surgeon may be tempted to remove it as an unexplained mass [4]. Abnormal position may result in atypical referred pain, misdiagnosed as Appendicitis or Pelvic inflammatory disease in women. Increase in renal transplants, vascular reconstruction and other urologic procedures require thorough knowledge of morphological variants of kidneys and their clinical significance. Here we present a case ectopic kidney noted at our hospital.

Ectopic and Mal-rotated kidney with bilateral hydronephrosis – Case report

“…Four rotational anomalies have been identified. Non-Rotation-Renal pelvis facing ventrally, Incomplete Rotation-Ventromedially, Reverse, and Excessive Rotation-Hilum faces laterally [1]. In our case, it is the excessive rotation-hilum faces laterally.…”

“…The embryogenesis of the kidney can be traced to the 4 th week of intrauterine life, where it begins as buds in the pelvic region [1]. By the 8 th week of life and with continued growth, the kidneys ascend gradually to their normal position, close to the ribs [1]. Located in the lumbar diaphragm fossae, the kidneys are usually known as retroperitoneal organs [2].…”

“…When the kidneys are not located in this normal position, it is referred to as being ectopic. It can be located anywhere along the course of its ascent or contra-laterally, referred to as "crossed" [1]. There is evidence of a relationship between vascularization and renal ascent [3].…”

“…Amongst the many morphological abnormalities of the kidneys are conditions of rotation which can be seen in normal kidneys as well as ectopic ones [4]. The incidence of ectopic kidney reported in the literature is 1:500 to 1:1100 while the incidence of one normal and one pelvic kidney is 1:800 to 1:3000, Ectopic thoracic kidney is 1:13000, Single pelvic kidney is 1:22000 and crossed renal ectopia 1:7000 [1]. *Corresponding author: A. Omodan, asking4biola@yahoo.com; Potential Conflicts of Interest (CoI): All authors: no potential conflicts of interest disclosed; Funding: This study was conducted as a part of the first anatomy annual congress in Rwanda, October 13-15, 2022 sponsored by the MoH, UR, UGHE, AUCA-ASOME, Operation Smile, CHUK and MMI; Academic Integrity.…”