The constellation of findings now suggested the diagnosis of cross. This may result in a single large fused kidney as shown below crossedfused ectopia. In 8590% of the crossed renal ectopia cases, the kidneys are partially or completely fused, hence given the name cfre. Ectopia can be simple, with the kidney located ipsilateral to its ureteral insertion, or crossed, with the kidney. After horseshoe kidney, crossed fused ectopia of the kidneys is the most frequent fusion abnormality of the urinary tract. Crossed fused renal ectopia is a rare congenital malformation, which is reported to be usually asymptomatic but may have varied presentations. Renal agenesis and ectopia dynamic radiology barnard. Most cases of renal ectopia remain asymptomatic during a persons lifetime and are diagnosed incidentally. Original research article crossed renal ectopia without. Cross fused renal ectopia with associated renal cell carcinoma ncbi. Crossed fused ectopia of the kidneys kidney international. If reflux into the ureteral ectopia is present, resection of distal ectopic ureter is necessary. Review of the literature since the appearance of wilmers1 excellent and comprehensive article in 1938 shows that this condition has been reported almost exclusively in the urologic. The left renal vein emerging posteriorly ascends parallel and to the right of right common iliac artery to drain into inferior vena cava ivc figure1, 3b.
Principales anomalias congenitas del aparato urinario. Crossed fused renal ectopia cfre is a markedly rare congenital malformation of the urinary system where one of the kidneys crosses the midline to become located on the opposite side of its ureter entrance to the bladder and the parenchymas of. To date, ureteral ectopia combined with renal dysplasia and urolithiasis has not been documented. A partial dislocation of a lens is termed lens subluxation or subluxated lens. Patients with crossed renal ectopia often have other organ and system malformations. As each kidney ascends, it rotates through 90 degrees such that the renal hilum is directed medially as the kidney reaches its final position. An ectopic kidney may cross over and can become fused with the other kidney crossed renal ectopia. In humans, crossed renal ectopia is a rare, usually asymptomatic, congenital malpositioning of the kidneys, involving wandering of one or both embryonic kidneys across the midline and usually fusion with its contralateral partner.
In this abnormality, both the kidneys are located on the same side most cases fused, figure 1 with. However, in cases of cross ectopia, renal tissue is usually fused and one kidney is absent. Crossed fused renal ectopia with renal calculus and gross. Renal ectopia should be distinguished from renal ptosis in which a normally situated kidney shifts to a lower position. Crossed renal ectopia is the location of the kidney on the contralateral side in respect to the ureteral orfice location in the bladder.
Ureteroscopic stone extraction in crossfused renal ectopia. Pielonefritis en ectopia renal cruzada y fusionada nefrologia. Find, read and cite all the research you need on researchgate. The sonographic appearance of this entity consists of a characteristic anterior andor posterior notch, difference in orientation of the 2 collecting systems in the fused kidneys, and absence of a kidney in the contralateral renal fossa, or. Dmsa renal scan a dmsa renal scan detects scarring of the kidneys, locates ectopic renal tissue, and provides an accurate differential renal function. Ectopic kidney renal ectopia causes, symptoms, diagnosis. The ureter of the lower kidney crosses the midline to enter the bladder on the. Ectopic kidney describes a kidney that is not located in its usual position. Common sheat ureteroneocystostomy ucn for a duplex kidney with closely spaced ureteral orifices. Pdf on jan 1, 2016, ramiro galvezvaldovinos and others published ectopia renal cruzada con fusion. It may remain undetected in the absence of abdominal pain or urinary infection. We report an unusual presentation of a case of crossed renal ectopia without fusion. Crossed renal ectopia is a rare congenital anomaly in which the kidneys are located on the same side, whereas the ureter of the ectopic kidney still descends to the normal location on the bladder. Crossed renal ectopia is a rare type of congenital malformation of the urinary system that shares a 12000 incidence.
Crossed fused renal ectopia is the fusion of both kidneys, with at least one kidney on the side opposite its normal location incidence 17000 births 1. Jun 03, 2015 this illustrations deals with one of the important renal anomalies, ectopic kidney. It can be a simple uncrossed ectopia in which one or both the kidneys are ectopic in position and in some cases a kidney is located. Rapid caudal growth results in the migration of the developing kidney from the pelvis to the retroperitoneal renal fossa, which lies on either side of the spine opposite the second lumbar vertebra. Clinically, renal ectopia is more readily recognized in females because they undergo. Pdf crossed fused renal ectopia with repeated kidney and.
Crossed renal ectopia refers to a kidney that has crossed from its side, to the other side. This anomaly has not been previously reported in association with tar syndrome. Pdf transplantation of crossed fused renal ectopia. Both of the kidneys are ectopic with the crossed ectopic right kidney lying superiorly and. Download free adobe acrobat reader dc software for your windows, mac os and android devices to view, print, and comment on pdf documents.
Thoracoscopic repair of renal ectopia associated with. Renal ectopia diagnostic imaging gomal journal of medical sciences julydecember 2008, vol. Fusion anomalies of the kidney are uncommonly encountered in clinical practice. When the kidney stays in the pelvis, it is called a pelvic kidney. Renal ectopia occurs when the kidney fails to ascend from its embryologic position in the fetal pelvis to its final position in the renal fossa. Pdf to report two cases of right crossed nonfused renal ectopia diagnosed. Bilateral ureteral ectopia with renal dysplasia and urolithiasis in a dog article pdf available in journal of the american animal hospital association 463. Crossed renal ectopia, renal anomaly, fusion, functional unit, solitary renal ectopia, atretic ureter. Crossed fused renal ectopia is a rare congenital anomaly of the urinary system. Crossed renal ectopia with fusion is a very rare condition, and crossed ectopia without fusion is much rarer. The identification of crossed fused renal ectopia is important for radiologists and sur. All symptomatic cdh cases must be treated with open or thoracoscopic repair.
Renal cell carcinoma is the most common solid tumour occurring within the kidney representing 23% of cancers diagnosed. Thoracic renal ectopia denotes either a partial or a complete protrusion of the kidney above the level of the diaphragm into the posterior mediastinum. A 45yearold man, during investigation for recurrent abdominal pain, was found to have an empty left renal fossa and right crossed renal ectopia with fusion on ultrasonography. An ectopic kidney is a kidney that does not grow in the proper location. This is the first report of crossed renal ectopia in the cat. The scan requires an injection of a small amount of radioactive substance tracer into a vein. Intrathoracic renal ectopia with concomitant congenital diaphragmatic hernia cdh is extremely rare.
Issn 23214287 305 original article crossed fused renal ectopia multidetector computed tomography study sharma v 1, ramesh babu c. Crossed renal ectopia is a rare congenital malformations where a kidney is located on the side opposite to side of its urethral insertion into the urinary bladder and is generally fused with the normally located ipsilateral kidney. A rare association of crossed fused renal ectopia bmc. Jun 24, 2016 simple renal ectopia refers to a kidney that is located on the proper side but is in an abnormal position. Left kidney is lengthened and renal concentration is inhomogeneous. Crossed fused renal ectopia radiology reference article. The fused type of crossed renal ectopia is relatively more common than the uncrossed type. The kidney will lie obliquely in the ipsilateral iliac fossa. Thought to result from aberrant metanephros development in which the normal displacement of the fetal kidneys from the pelvis to the lumbar fossae is altered or inhibited. Crossed fused renal ectopia refers to an anomaly where the kidneys are fused and located on the same side of the midline. Crossed fused renal ectopia cfre is a markedly rare congenital malformation of the urinary system where one of the kidneys crosses the midline to become located on the opposite side of its ureter entrance to the bladder and the parenchymas of the two kidneys fuse.
Blue arrow marks aorta, orange arrows mark renal units. If the kidney crosses to the other side of the body, it is called crossed renal ectopia. The incidence, cause and significance of hydronephrosis in patients with renal ectopia are unknown. About 20% of patients with crossed renal ectopia also have vur guarino et al. Often, the crossed kidney is fused with the uncrossed kidney, from the online textbook of urology by d. Ureteral ectopia medigoo health medical tests and free. This survey was conducted to study the clinical profile and the challenges posed in the management of this entity. Crossed fused renal ectopia with renal calculus and gross hydronephrosis a case report author. It is usually asymptomatic and does not require treatment. Abstractrenal ectopia is a rare anomaly which may occur due to an abnormal ascent of the kidney.
Crossed renal ectopia with fusion in a female feline. An aberrant renal artery arising from the iliac artery. Our patient is a 16yearold adolescent male, previously fit and healthy, who presented with acute onset of. Crossed renal ectopia with fusion in a cat allworth. For interpretation of the references to colour in this figure legend, the reader is referred.
An ectopic kidney may remain in the pelvis, near the bladder pelvic kidney. Renal ectopia is often linked to birth defects in other organ systems. Crossed renal ectopia refers to a kidney that has crossed from the left to the right side or vice versa so that both kidneys are located on the same side of the body. The most recent resume published of the unfused type of crossed renal ectopia was by j. Demonstration of crossed renal ectopia is important because it is a predisposing factor for obstruction, infection, and neoplasia of the urinary system. Crossed fused renal ectopia is a rare congenital anomaly, and is mostly detected incidentally. This illustrations deals with one of the important renal anomalies, ectopic kidney.
It results from the kidney failing to ascend from its origin in the true pelvis or from a superiorly ascended kidney located in the thorax. We can, therefore, make the prenatal diagnosis of a horseshoe kidney by combining 2d and 3d power doppler sonographic findings. Re, proves a good concentration of an ectopic kidney. Since these pathologies are frequently asymptomatic, the diagnosis is most commonly madeafter a routine imaging studies due to other causes or when recurrent uti or urinary obstruction are associated. In this case, a male patient was admitted to our hospital because of doublelimb edema, hematuria and proteinuria and all preoperative examinations indicated that the left kidney. We report a case of tar syndrome with crossed fused renal ectopia. Crossed renal ectopia is one of the rarest urinary system anomalies. Adobe acrobat reader dc download free pdf viewer for. Thrombocytopenia and absent radius syndrome tar is a rare genetic disorder. Crossed renal ectopia is a congenital anomaly which usually goes unnoticed as most cases are asymptomatic. If excretory urography fails to reveal the left kidney, demonstration of the normal colon will exclude renal agenesis or ectopia. The tracer travels to the kidneys by the blood stream.
An ectopic kidney, also known as renal ectopia, is a congenital renal anomaly characterized by the abnormal location of one or both of the kidneys. These are broadly divided into two distinct varieties. Epidemiology the estimated incidence is around 1 out of births 1. In many cases, the two kidneys are fused together, yet retain their own vessels and ureters.
Ureteral ectopia is often present in combination with other urinary abnormalities, such as hydroureter, hydronephrosis, pyelonephritis, bladder hypoplasia, and the presence of an intrapelvic bladder neck associated with a short urethra. Five cases of crossed fused renal ectopia, all confirmed by either computed tomographic scan or intravenous urography, were diagnosed sonographically. In the present case, there were no abnormalities andor alteration of the renal function. C rossfused renal ectopia is the second most common renal fusion anomaly after horseshoe kidney, with an incidence of 1. There appears to be a slight left sided predominance of 1. Ureteropyelostomy or ureteroureterostomy for a duplex kidney and widely spaced ureteral orifices.
Crossed fused ectopia of kidney an account of tertiary. Pdf bilateral ureteral ectopia with renal dysplasia and. Renal ectopia is also not uncommon and is found in 1 of 2100 to 3000 autopsies. During this treatment, ultrasonography revealed an empty left renal fossa with a crossed left renal ectopia fused to the right kidney. Pdf crossed renal ectopia cre is a rare congenital anomaly in which both kidneys are.
Abstract among the anomalies of the upper urinary tract are the anomalies of ascent, which includes simple renal ectopia, and the anomalies of form and fusioninclude, which s crossed renal. Both kidneys are located on the same side of the body. The anatomic splenic flexure of the colon occupies the renal fossa in patients with left renal agenesis or ectopia and presents a characteristic appearance on radiographs and contrast enema studies. Ectopic kidney is a birth defect in which a kidney is located at an abnormal location. It is more often seen at autopsy than in clinical practice.
Aug 22, 2017 sistema excretorurinario os rins e a filtragem do sangue anatomia humana videoaula 030 duration. Dec 15, 2019 agenesis or ectopia of the kidney is frequently accompanied by characteristic malposition of specific portions of the bowel. Is a complete urological evaluation necessary in all newborns. Ectopic kidney is a congenital defect that results due to improper positioning of the kidney during fetal development. We report two male patients who had unremarkable clinical findings. Stone formation in these patients is rare and the majority remain asymptomatic throughout their lifetime. Crossed fused renal ectopia of the superior ectopia type leylaakdogan, 1,2 alikemaloguz, 1,2 tarkanergun, 3,4 andihsanergun 5 department of internal medicine, ufuk university school of medicine, ankara, turkey. This case report is the first in veterinary medicine to describe a crossed renal ectopia with fusion of right kidney in a female. In cases of normal variation, aberrant renal arteries arise from the aorta between t.
Less commonly, a kidney may ascend to the other side with 2 kidneys on one side of the abdomen. Information here will help you talk with your urologist if you or your child has an ectopic kidney. It is an autosomal recessive disorder characterised by radial aplasia and thrombocytopenia that may have additional anomalies. Crossed renal ectopia without fusionan unusual cause of. Renal cell carcinoma in an ectopic pelvic kidney in a.