Surgeons Children's Republican Clinical Hospital faced with a rare anomaly of the kidneys
"Our little patient was observed from birth by doctors with hydronephrotic transformation on the left. He was repeatedly examined at the place of residence. Still, all this time, the anomaly "cleverly hid." It was noticed only recently during ultrasound diagnostics," says Dr. Rashit Baybikov, a pediatric urologist.
The most common disease that provokes a horseshoe kidney is hydronephrosis, which develops due to the ureter's compression by the isthmus. It is worth noting that this anomaly can induce diseases such as pyelonephritis or nephrolithiasis, which in turn can cause chronic kidney failure.
"To clarify the diagnosis, the patient underwent kidney angiography, which revealed an additional lower polar vessel, which was the cause of the violation of the outflow of urine from the left segment of the horseshoe kidney. And only during the surgical intervention, a rare case of this anomaly in the form of a retrocaval isthmus was established," the doctor explained.
It is also worth noting that it brought complexity when performing surgical treatment: the isthmus of the kidney is usually located in front of large vessels (aorta, inferior vena cava, common iliac vessels) and the solar plexus, which are pressed against the spinal column by the isthmus. In 6-10 % of cases, the horseshoe kidney's isthmus is located between the aorta and the inferior vena cava. Very rarely it happens between the vertebral column and the vessels, as in this case.
The operation was successful, and the child was discharged home with improvement.