Unveiling the confusion in renal fusion anomalies: role of imaging

Kubihal, Vijay; Razik, Abdul; Sharma, Sanjay; Das, Chandan Jyoti

doi:10.1007/s00261-021-03072-1

Cited by 5 publications

(11 citation statements)

References 22 publications

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“…CFRE is commonly an incidental finding in humans; it is rarely reported to be the cause of renal insufficiency but rather more commonly associated with complications such as pyelonephritis, recurrent urinary tract infection, nephrolithiasis, vesicoureteral reflux, hydronephrosis and cancer. 1,2,14 Ultrasonography is a useful imaging modality to evaluate the renal morphology in cats. 14,15 Common US findings of patients with chronic kidney disease include increased cortical echogenicity, abnormal corticomedullary distinction, poorly discernable internal architecture, abnormal shape and decreased renal size.…”

Section: Discussionmentioning

confidence: 99%

“…3 A fused pelvic kidney is the least common type of renal fusion described in human medicine, consisting of a complete renal fusion at the level of the pelvic cavity and two short orthotopic ureters. 1,4,5 There are several published classifications of CFRE in humans: 6 lump kidney is classified as extensive renal fusion that forms an irregular mass/lump; disc kidney displays fusion along the medial concave surface of both kidneys; inferior ectopia is when the ectopic kidney is fused to the inferior pole of the orthotopic kidney; superior ectopia is when the ectopic kidney is fused to the superior pole of the orthotopic kidney; sigmoid or S-shaped kidney is when the ectopic kidney is axially rotated and inferior to the orthotopic kidney; and L-shape kidney is characterized by the ectopic kidney being transversely oriented and the upper pole of the ectopic kidney being fused to the lower pole of the orthotopic kidney. 6,7 Inferior crossed fusion is reported to be the most common type in humans.…”

Section: Introductionmentioning

confidence: 99%

“…Renal fusion is a rare condition in veterinary medicine but is a relatively common congenital malformation of the urinary tract in humans. 1 – 3 The three main types described in the literature are horseshoe kidneys, crossed fused renal ectopia (CFRE) and fused pelvic kidney (pancake kidney). 1 Renal fusion is often asymptomatic but has been reported in association with other congenital malformations and may predispose to several complications, such as recurrent urinary tract infections or calculi.…”

Section: Introductionmentioning

confidence: 99%

“… 1 – 3 The three main types described in the literature are horseshoe kidneys, crossed fused renal ectopia (CFRE) and fused pelvic kidney (pancake kidney). 1 Renal fusion is often asymptomatic but has been reported in association with other congenital malformations and may predispose to several complications, such as recurrent urinary tract infections or calculi. 2 Horseshoe kidney is the most common renal fusion anomaly in humans, accounting for 90% of cases.…”

Section: Introductionmentioning

confidence: 99%

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Imaging features of renal ectopia and fusion in 13 cats

Slinkard,

Anson,

Specchi

et al. 2023

Journal of Feline Medicine and Surgery

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Case series summary A retrospective multicenter case series of renal fusion anomalies in cats was investigated. The aim of this study was to describe the imaging characteristics (radiography, ultrasonography and CT) of renal ectopia and fusion in cats. A total of 13 feline patients (median age 9 years) were included in this multicentric retrospective study. Ultrasound was available in 12/13 cases, radiographs in 4/13 cases and CT in 3/13 cases. Of the 13 cases, seven were left to right fusions, four were right to left fusions, one was on the midline and one was in the pelvic inlet. Adopting a human classification system, there were five lump kidneys, four disc kidneys, one horseshoe kidney, one caudal ectopia, one L-shaped kidney and one pelvic kidney. In 2/13 cases, additional congenital malformations were noted, including an azygous continuation of the caudal vena cava and a peritoneal-pericardial diaphragmatic hernia. Relevance and novel information This study provides further description of the imaging findings in feline patients with fused renal ectopia. The morphologic characteristics of the fused kidneys in cats appear similar to what is published in the human literature. Renal fusion might be an incidental finding in cats, but further investigations are necessary to determine their clinical relevance.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Imaging features of renal ectopia and fusion in 13 cats

Slinkard,

Anson,

Specchi

et al. 2023

Journal of Feline Medicine and Surgery

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“…However, the crossed kidney may be obscured due to overlapping structures or bowel gas. CT and/or MRI can accurately show the complex anatomy and stone site 15 . In this patient, the abdominal viscera and great vessels' anatomical relationships were evaluated, and bilateral stones were detected by CT plain scan (Figure 1).…”

Section: Discussionmentioning

confidence: 99%

Case report: Crossed fused renal ectopia with stones: A surgical challenge overcome by robotic surgery

Chai

2023

Robotics Computer Surgery

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BackgroundCrossed fused renal ectopia (CFRE) is an extremely rare congenital anomaly of the urinary tract that is prone to stone formation. The surgical treatment of CFRE with stones is challenging due to anatomical abnormalities.Materials and MethodsRight kidney stones were treated by flexible ureteroscopic lithotripsy (FURSL) and left kidney stones were treated by robotic surgery.ResultsThe authors present an unreported case of bilateral renal stones in a patient with CFRE, which was successfully treated by robotic pyelolithotomy combined with FURSL. The procedure was manoeuverable, and the stone‐free rate was satisfactory.ConclusionsCFRE with stones (S‐shaped kidney) present a surgical challenge due to anatomical abnormalities and a high stone burden. The authors recommend robotic pyelolithotomy with or without FURSL as a viable treatment option for stones with similar anatomical abnormalities.

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Association of Upper Urinary Tract and Renal Vasculature Anatomical Variations: Evidence From Northern Nigeria

UMAR,

ISYAKU,

AJI

et al. 2024

Preprint

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Background The knowledge of anatomical variations as they relate to the urinary system is valuable, especially in the proper evaluation and conduction of surgical as well as interventional procedures of the urinary tract. The study aimed to determine the prevalence and possible association between anatomical variations of the upper urinary tract and renal vasculature. Methodology : A total of 200 computed tomograms were generated with Toshiba Aquilion Prime 160-slice scanner and analyzed for the presence of potential anatomical variations using a Vitrea multimodality work station capable of image post processing by two expert radiologists. Results The most common anatomical variation of the upper urinary tract found on the right was extra-renal bifid pelvis at 25 (12.5%) while on the left it was baggy extra-renal pelvis at 27 (13.5%). Early branching hilar renal artery and accessory superior polar renal artery both at 19 (9.5%) were the most common renal vasculature variations on the right and left respectively. There was statistically significant association between anatomical variations of the upper urinary tract and renal vasculature with a p-value of < 0.001. Conclusion This study showed that anatomical variations of the upper urinary tract are commoner on the right side while for renal vasculature they are commoner on the left. There was a statistically significant association between the anatomical variations of the upper urinary tract and that of the renal vasculature indicating an increasing likelihood of one occurring if the other is present.

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Unveiling the confusion in renal fusion anomalies: role of imaging

Cited by 5 publications

References 22 publications

Imaging features of renal ectopia and fusion in 13 cats

Imaging features of renal ectopia and fusion in 13 cats

Case report: Crossed fused renal ectopia with stones: A surgical challenge overcome by robotic surgery

Association of Upper Urinary Tract and Renal Vasculature Anatomical Variations: Evidence From Northern Nigeria

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