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Anatomical Study of the Horseshoe Kidney
Tijerina de la Garza,Octavio; Uresti,Jaime; Urrutia de la Vega,Edgar; Elizondo-Oma?a,Rodrigo Enrique; Guzmán-López,Santos;
International Journal of Morphology , 2009, DOI: 10.4067/S0717-95022009000200030
Abstract: we present the anatomical study of a horseshoe kidney found during dissection practice at the human anatomy laboratory. the specimen consisted of a renal mass joined at its lower poles by an isthmus composed of renal parenchyma. we provide a macroscopic description of renal blood supply and the excretory system. we also discuss the anatomic and embryologic importance of this anomaly.
Tumors of the horseshoe kidney: Characteristics and literature review
Petrovi? Milan,Andrejevi? Vladan,?ura?i? Ljubomir,Stamenkovi? Vladimir
Acta Chirurgica Iugoslavica , 2012, DOI: 10.2298/aci1201053p
Abstract: The aim of this paper is to point out the significance of the rare urinary system anomaly such as horseshoe kidney. Tumors of the horseshoe kidney are rarely described as single cases in literature. Bilateral tumors of the horseshoe kidney can present a health and therapeutically challenge. In this paper we have analyzed characteristics of the horse shoe kidney tumors and their diagnostics. Primary means of the horseshoe kidney tumors treatment are surgical with different techniques depending on the size, presentation of the tumor and other indications. The review of the available literature is also included.
Horseshoe kidney: a case report  [cached]
Naveena S,Mrudula C
International Journal of Research in Medical Sciences , 2013, DOI: 10.5455/2320-6012.ijrms20130833
Abstract: The horseshoe kidney was originally regarded as a rare anatomical curiosity, but with the aid of retrograde pyelogram, intravenous urogram and renal arteriograms in this present age of diagnosis, the incidence of horseshoe kidney is estimated at 1 in 200-400 individuals or 1 in 700 autopsies and usually remains asymptomatic. The present report is concerned with a case of horseshoe kidney, which was observed during routine cadaveric dissection, for student education in anatomy dissection hall of Osmania medical college, in a male cadaver. The kidneys formed a U-shaped structure as a result of fusion at the inferior poles of the original kidneys by a parenchymatous isthmus. As a whole, the structure presented a typical horseshoe shape. The location of the kidney was lower than that of the normal kidney. The renal arterial system was almost normal except for a surplus artery into the isthmus that directly originated from the aorta, at the origin of inferior mesenteric artery. Venous drainage of both the kidneys and the isthmus was through two veins which opened independently into the inferior vena cava. The hila on both sides opened towards the ventral direction, and the ureters descended in front of the isthmus and entered the bladder normally. This report is being made because it affords material for a review of embryological and gross anatomy findings in a case of horseshoe kidney, which could help in a thorough urologic evaluation in diagnosed cases prior to any surgical intervention. [Int J Res Med Sci 2013; 1(3.000): 304-307]
Conjoined twins with a horseshoe kidney
M Modi, L Kramer
South African Journal of Radiology , 2009,
Abstract: Conjoined twins are rare variants of monozygotic twins. There are many types of conjoined twins, usually classified according to the site of fusion. The most common type of renal fusion anomaly is the horseshoe kidney, comprising two distinct functioning kidneys on either side of the midline, which are more likely to be connected at the lower poles. We report on a 30-year-old woman who presented to the antenatal clinic at Chris Hani Baragwanath Hospital, Soweto. Fetal magnetic resonance imaging revealed thoraco-omphalopagus conjoined twins with complex thoracic and abdominal structures, including a horseshoe kidney that was confirmed on postnatal computed tomography screening. Our patient was classified as a thoraco-omphalopagus type, with fusion of the thorax and the mid-trunk.
Percutaneous Nephrolithotomy of Kidney Calculi in Horseshoe Kidney  [cached]
Mohammad Reza Darabi Mahboub,Ali Ahanian,Maryam Zolfaghari
Urology Journal , 2007,
Abstract: Introduction: The aim of this study was to evaluate percutaneous nephrolithotomy (PCNL) in horseshoe kidneys with calculi. Materials and Methods: Between 1995 and 2005, we performed PCNL in 9 patients with horseshoe kidney. In 3 of them, there was a single calculus and the rest had multiple calculi in the pelvis and at least 1 in the calyxes. Ultrasonography, plain abdominal radiography, and intravenous urography (IVU) were performed in all patients. We used fluoroscopy for entering the system and then, pneumatic or ultrasonic lithotripsy was used. Results: In all except 1 patient (88.9%) we could access the system. Single calculi in 3 patients were removed. In 5 patients with multiple calculi, the calculus causing obstruction was removed, and in 3, the calculi located in the calyxes were removed too. Consequently, 66.7% were stone-free at the end of the procedure. In 2 patients, there were residual calculi in the calyxes and they underwent candidates for extracorporeal shockwave lithotripsy. Conclusion: Percutaneous nephrolithotomy can be used in patients with horseshoe kidney if the patient selection is appropriate and the surgeon is experienced enough. The success rate and complications are the same as the patients with normal anatomy. However, access to the lower calyx is more difficult due to its anatomic status.
Renal cell carcinoma in a horseshoe kidney  [PDF]
Had?i-?oki? J.,?olovi? V.,Pej?i? T.,Dragi?evi? D.
Acta Chirurgica Iugoslavica , 2009, DOI: 10.2298/aci0901097h
Abstract: A case of an adenocarcinoma within a horseshoe kidney (HK) is presented. Male patient presented with a history of a painless hematuria. A contrast enhanced magnetic resonance (MR) scan showed a horseshoe kidney. A large soft tissue mass was also noted on the right side. Kidney was receiving supply from two arteries on the left side and one at the right side. Angiography of the right renal artery demonstrated hypervascular tumor staining. The kidney was approached through midline abdominal incision, and a right heminephrectomy was performed. The histopathology examination showed pT2, grade 2 renal cell carcinoma. To conclude, angiography is indispensable for guiding surgical interventions.
A horseshoe kidney with partial duplex systems  [PDF]
Ongeti KW,Ogeng’o J,Saidi H
International Journal of Anatomical Variations , 2011,
Abstract: During routine dissection, we identified a horseshoe kidney arrested inferior to the inferior mesenteric artery in a middle-aged male cadaver. On further dissection, the kidneys were fused inferiorly, both hila were wide and the kidneys had bilateral duplicated renal arteries and ureters. Horseshoe kidneys could be associated with bilateral duplex systems.
Segmental Renal Ischemia following Transplantation of Horseshoe Kidney as Separate Allografts  [PDF]
J. T. Foster,P. E. Morrissey
Case Reports in Transplantation , 2013, DOI: 10.1155/2013/852127
Abstract: Introduction. Horseshoe kidney is a congenital anomaly that presents unique challenges for the transplant surgeon. The mere presence of horseshoe kidney should not preclude consideration for transplantation. Case Report. A 33-year-old women suffering from end-stage renal disease underwent deceased donor renal transplant with a divided horseshoe kidney. We present a postoperative complication and the technical strategy for transplant salvage. The patient currently has excellent graft function. Discussion. Horseshoe kidneys do present challenges for successful transplantation. Though case reports of successful transplantation are increasing, we present a technical complication and successful transplant salvage strategy. Technical descriptions in the literature of successful back-table preparation strategies should help more transplant surgeons to begin to utilize this resource. Conclusion. This study concludes that horseshoe kidneys can be successfully used for transplantation and provides a technical strategy to salvage the transplant after a unique complication associated with these donor kidneys. 1. Introduction Horseshoe kidney is a congenital anomaly found in approximately 1 in 400 persons. With 6,000 to 8,000 deceased donors per year in the United States, utilization of horseshoe kidneys for renal transplantation would afford more organs for transplant recipients. The first case reports of transplanted horseshoe kidneys were described in 1975 by Nelson and Palmer [1]. A recent review found only 55 reported cases of transplanted horseshoe kidney in the literature [2]. Of these cases, 15 were transplanted en bloc. Two were split horseshoe kidneys from living donors, and the remaining 38 were split from cadaveric donors and then transplanted. Several factors must be considered when deciding to utilize a horseshoe kidney for transplantation including renal size (a surrogate for nephron mass), renal vascular anomalies, and urologic anatomy. Only one-third of horseshoe kidneys have normal renal arterial supply [2]. As the kidney is supplied by functional end arteries, failure to preserve inflow to the kidney will result in ischemia. We report a unique urological complication encountered in one of the two renal transplant recipients related to aberrant blood supply in a horseshoe kidney. 2. Case Report 2.1. Donor Anatomy and Surgery The kidneys from a 55-year-old donor following a cerebrovascular accident and brain death were accepted for transplantation. The donor had a congenital horseshoe kidney and normal creatinine (0.8?mg/dL). Each half of the
Congenital arteriovenous fistula of the horseshoe kidney with multiple hemangiomas
Lazi? Miodrag,Had?i-?oki? Jovan,Ba?i? Dragoslav,A?imovi? Miodrag
Srpski Arhiv za Celokupno Lekarstvo , 2012, DOI: 10.2298/sarh1208508l
Abstract: Introduction. Congenital renal arteriovenous fistulas (AVF) are rare, especially if they are associated with other developmental renal anomalies. Case Outline. A 34-year-old female was hospitalized due to total painless hematuria and bladder tamponade. Excretory urography revealed a horseshoe kidney with normal morphology of pyelocaliceal system and ureters. Aortography and selective renovasography detected a cluster-like vascular formation with multiple arteriovenous fistulas (AVF). Due to a large AVF gauge and poor flow of the efferent vein to the inferior vena cava, a surgical procedure of two renal artery segmentary branches ligation and division was performed. During the operative procedure, the presence of multiple superficial renal hemangiomas was detected. Conclusion. Although selective arterial embolization represents the preferable treatment option, conventional surgery remains favorable alternative in selected cases with large and complex AVF.
Neoplasia in horseshoe kidney with pyelic fusion and crossed single ureter
Costa, Renato P.;Schaal, Carlos H.;Navarro, Fábio C.;
International braz j urol , 2004, DOI: 10.1590/S1677-55382004000400010
Abstract: horseshoe kidney with pyelic fusion and crossed single ureter is a rare anomaly, with only 3 cases described in the literature. such anomaly can be accompanied by other abnormalities, such as congenital scoliosis and situs inversus totalis. we present one case of this malformation associated with malignant neoplasia, treated with partial nephrectomy.
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