Congenital renal fusion and ectopia in the trauma patient. Original research article crossed renal ectopia without fusion. 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 1. Renal ectopy and fusion are common congenital anomalies of the kidney and urinary tract cakut, and result from disruption of the normal embryologic migration of the kidneys. Urological and nephrological findings of renal ectopia. Both kidneys are located on the same side of the body. An ectopic kidney is a kidney that does not grow in the proper location.
In cases of normal variation, aberrant renal arteries arise from the aorta between t11 and l4. Renal ectopia was diagnosed in 41 cases, of which 26 63% were simple renal ectopia, ie unilateral pelvic kidney. Renal ectopia describes a kidney that fails to reach its standard location. This anomaly has not been previously reported in association with tar syndrome. Lump type crossed fused renal ectopia with bilateral vesicoureteral reflux. This anomaly is commonly associated with continuous or intermittent urinary incontinence.
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. The ultrasonography of abdomen showed the evidence of renal ectopia on right side. Pdf diagnosis and treatment of crossed testicular ectopia. In our case, the presence of a short ureter and normal development of the spine supported the. Although skeletal and genitourinary abnormalities most commonly accompany this condition, vesicoureteral reflux vur has been described in only a few cases. Crossed renal ectopia refers to a kidney that has crossed from its side, to the other side. Letters to the editor 359 aberrant renal arteries may be a feature of renal cross ectopia or horseshoe kidney, or may be a normal variation2. Thrombocytopenia and absent radius syndrome tar is a rare genetic disorder. A partial dislocation of a lens is termed lens subluxation or subluxated lens. This article is concerned with observations in 17 patients with renal fusion and ectopic abnormalities. Letters to the editor 359 obstetrics and gynecology. The incidence of unfused crossed renal ectopia, however, has been reported to be 1 in 75,000 autopsies, an incidence ten times lower than that of crossedfused renal ectopia felzenberg and nasrallah, 1991. If the kidney crosses to the other side of the body, it is called crossed renal ectopia.
Ramesh babu 1, bindu agrawal 2, vinay sharma 3, arjun kumar 4, ravi jain 5, o. Ectopia lentis is a displacement or malposition of the eyes crystalline lens from its normal location. 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 with renal calculus and gross hydronephrosis a case report author. Crossed fused renal ectopia radiology reference article. An ectopic kidney may remain in the pelvis, near the bladder pelvic kidney.
In % of the crossed renal ectopia cases, the kidneys are partially or completely fused, hence given the name cfre. Ninety percent of the crossed ectopic kidneys are fused 24. Crossed renal ectopia cre is a rare congenital anomaly that is frequently associated with gastrointestinal, cardiovascular, genital and bone malformations. The majority of pediatric patients are asymptomatic, but they often have. Crossed fused renal ectopia is thought to result from the abnormal development of the ureteric bud and metanephric blastema during the fourth to eighth weeks of gestation. Here we describe a case of thoracic kidney in an 8 year old female who came with a history of pain in right iliac fossa. Agenesis or ectopia of the kidney is frequently accompanied by characteristic malposition of specific portions of the bowel. In order to suggest a nomenclature which would be best suited for this condition, i consulted dr. 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.
We report a case of tar syndrome with crossed fused renal ectopia. Crossed renal ectopia is a congenital anomaly which usually goes unnoticed as most cases are asymptomatic. Here, we present two unique cases of scre complicated by highgrade vur concomitant with posterior urethral valve in one case and hypospadias in the. A rare association of crossed fused renal ectopia bmc. Crossed renal ectopia is one of the rarest congenital malformations where a kidney is located on the side. 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. 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. A frequent cause of pseudocrossed renal ectopia is the insidious. Crossed renal ectopia, the complete congenital displacement of one kidney to the contralateral side, is a rare radiologic finding, previously reported in the urologic, rather than general surgical, literature. Abdominal ectopia 15% the type of ectopia cordis your child has can also depend on whether the heart is totally uncovered, covered by a serous membrane or covered by skin. Abnormalities of renal ascent during fetal development are thought to be the cause.
Ectopia cordis ec is a rare malformation, occurring in 5. Unilateral fused kidney with inferior ectopia is the next most common fusion anomaly with an incidence of 1. Lump type crossed fused renal ectopia with bilateral. Crossed fused renal ectopia with renal calculus and gross. Crossed renal ectopia cre with fusion is a rare congenital anomaly of kidney. In many cases, the two kidneys are fused together, yet retain their own vessels and ureters. It is an autosomal recessive disorder characterised by radial aplasia and thrombocytopenia that may have additional anomalies. In 8590% of the crossed renal ectopia cases, the kidneys are partially or completely fused, hence given the name cfre. Nevertheless, the ectopic kidneys ureter crosses the midline to insert in its normal position in the bladder. 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. Although children with these anomalies are generally asymptomatic, some children develop symptoms due to complications, such as infection, renal calculi, and urinary. Crossed renal ectopia cre is a rare congenital anomaly that is frequently associated. Transposed renal ectopia, crossed renal ectopia, crossed renal dystopia, and other terms, all apparently designate the same condition.
Ectopia definition, the usually congenital displacement of an organ or part. It is much k ey w o rd s more common to find a crossed fused renal ectopia of the. Problem of fused kidneys our observations international archives. In transverse or crossed testicular ectopia, the affected gonad lies in the same canal as the normally descended testis. More than 90% of crossed renal ectopia results in fusion. Renal ectopia diagnostic imaging gomal journal of medical sciences julydecember 2008, vol. Crossedfused renal ectopia is the second most common variety of renal fusion, with an incidence of 0. Depending on the type of ectopia cordis, as well as the associated heart defects, our team will be better able to predict the outcomes and treatment options for your child. Crossed renal ectopia without fusionan unusual cause of.
During a 5yr span, three children with this form of ectopia were seen. This occurs in about 1 in 700 on ultrasound screenings caiulo et al. Crossed renal ectopia is classified into 4 main categories. Crossed fused renal ectopia is a rare congenital anomaly of the ascent of the kidney. Anomalies of form and fusion, crossed renal ectopia with and without fusion. A rare case of pseudocrossed renal ectopia jama surgery. In 32% of patients the diagnosis was made during prenatal screening. Crossed renal ectopia is classied into main categories. Simple renal ectopia refers to a kidney that is located on the proper side but is in an abnormal position. However, in cases of cross ectopia, renal tissue is usually fused and one kidney is absent. To the best of our knowledge, only 35 cases of crossed renal ectopia involving calculi and 30 cases of cre associated with renal carcinoma have been reported to date patient concerns. Information here will help you talk with your urologist if you or your child has an ectopic kidney.
Patients with thoracic kidneys are usually asymptomatic and the condition is discovered during radiological evaluation for other conditions. The impact of renal fusion and ectopia on aortic surgery. During this treatment, ultrasonography revealed an empty left renal fossa with a crossed left renal ectopia fused to the right kidney. Ramesh babu, associate professor of anatomy, muzaffarnagar. Ureteral ectopia description, causes and risk factors. Ectopic kidney describes a kidney that is not located in its usual position. Pyelonephritis in crossedfused renal ectopia nefrologia english. Crossed fused renal ectopia refers to an anomaly where the kidneys are fused and located on the same side of the midline. Right crossed nonfused renal ectopia is an uncommon congenital anomaly with a higher incidence in males. A solitary kidney must be evaluated for associated anomalies such as duplication, horseshoe kidney, or crossed renal ectopia. The ureter of the lower kidney crosses the midline to enter the bladder on the contralateral side. Crossed renal ectopia cre is a rare congenital anomaly consisting of the transposition of a kidney to the opposite side.
A ct was done demonstrating crossed unfused renal ectopia with two rightsided kidneys and an absent left kidney, with laceration injury to the more anterior and inferior rightsided kidney, and hemoperitoneum in multiple abdominal quadrants figures 2a, 2b, and 2c. Pdf to report two cases of right crossed nonfused renal ectopia diagnosed in male patients about 30 years of age who arrived to emergency centres. 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. The estimated incidence is around 1 out of births 1. The most common form is unilaterally fused kidneys with inferior ectopia, slightly more often the crossing from left to right. 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. Embryologically, renal ectopia may be caused by vitiated cephalad growth of the ureter or impaired straightening of the developing vertebral column leading to failure of renal ascent, or diminished embryonal caudal growth away from the renal blastema2. 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. Crossed fused renal ectopia is a rare congenital malformation, which is reported to. Ureteral ectopia is a congenital abnormality of the terminal segment of one or both ureters in which the ureteral orifice is located at a site other than the trigone of bladder. Five cases of crossed fused renal ectopia, all confirmed by either computed tomographic scan or intravenous urography, were diagnosed sonographically. This anomaly may be observed as a solitary kidney during initial evaluation.
Pdf crossed fused renal ectopia is a rare congenital malformation, which is reported to be usually asymptomatic but may have varied. Ectopia cordis, a successful single stage thoracoabdominal. Crossed fused renal ectopia multidetector computed tomography study sharma v 1, ramesh babu c. Ureteral ectopia medigoo health medical tests and free. 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. Our patient is a 16yearold adolescent male, previously fit and healthy, who presented with acute onset of abdominal pain. After horse shoe kidney, crossed fused ectopia of the kidneys is the most frequent fusion abnormality of the urinary tract with a male predominance of 3. Prevalence of renal ectopia by imaging international. When the kidney stays in the pelvis, it is called a pelvic kidney. Three patients had occlusive disease, one may have had renal artery occlusion, and had aneurysmsthree thoracoabdominal and 10 infrarenal. An ectopic kidney may cross over and can become fused with the. Pseudocrossed renal ectopia refers to the acquired displacement of the kidney to the other side. Ectopic kidney is a congenital defect that results due to improper positioning of the kidney during fetal development. Resulting from aberrant migration andcrossing of the midline of the metanephric blastema and ureteral bud, cfre is thought to develop during 4th to 8th weeks of.
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