Horseshoe kidney presenting with features of left ureteropelvic junction obstruction—insights into management: a case report and review of the literature

Abstract Background Horseshoe kidney is the most common renal fusion anomaly, occurring in approximately 1 in 500 individuals worldwide. It is characterized by abnormalities in kidney position, rotation, and vascular supply. While often asymptomatic, horseshoe kidneys can lead to urological complica...

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Main Authors: Philipo Felix Mwita, Charles John Nhungo, Amini Mitamo Alexandre, Sylvia Bedas Nsato, Theofilo Mmbando, Gabriel Mtaturu, Obadia Nyongole, Charles A. Mkony
Format: Article
Language:English
Published: BMC 2025-01-01
Series:Journal of Medical Case Reports
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Online Access:https://doi.org/10.1186/s13256-024-04981-7
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Summary:Abstract Background Horseshoe kidney is the most common renal fusion anomaly, occurring in approximately 1 in 500 individuals worldwide. It is characterized by abnormalities in kidney position, rotation, and vascular supply. While often asymptomatic, horseshoe kidneys can lead to urological complications, primarily due to ureteric obstruction and impaired urinary drainage.Although ureteropelvic junction obstruction (UPJO) is uncommon in horseshoe kidneys, its occurrence presents unique diagnostic and management challenges. This case explores the etiology, clinical presentation, and surgical management of UPJO in a patient with a horseshoe kidney, highlighting the critical role of urologists in addressing these anatomical and functional complexities. Case presentation We report the case of a 3-month-old African male infant who presented with a two-month history of excessive crying and symmetrical abdominal distension. Radiological evaluation revealed a horseshoe kidney with decreased parenchymal thickness in the left kidney and marked hydronephrosis of the pelvis and calyces, with abrupt cessation at the left ureteropelvic junction. Surgical correction of the obstruction was performed successfully. The patient was followed for six months, during which he remained symptom-free with normal renal function tests. Conclusion Ureteropelvic junction obstruction in a horseshoe kidney presents unique anatomical challenges. Symptomatic cases require thorough imaging for diagnosis and surgical planning. Pyeloplasty is the typical surgical intervention, meticulously planned to address these complexities. This ensures effective relief of obstructions and proper urinary drainage.
ISSN:1752-1947