Bilateral pelvic kidneys with upper pole fusion and malrotation: a\xa0 case report and \xa0review of the\xa0literature

Nicholas Farkas,Omer Ali Mohamed Ahmed Alawad,Alnasri Mohammed Abuagla,Mohammed Mahgoub Mirghani Ahmed,Hussam S Khougali

doi:10.1186/s13256-021-02761-1

Nicholas Farkas, Omer Ali Mohamed Ahmed Alawad + Show 3 more

Open Access

https://doi.org/10.1186/s13256-021-02761-1

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Abstract

BackgroundThe incidence of ectopic kidneys is 1:12,000 clinically and 1:900 postmortem. Patients with pelvic mal-rotated kidneys are more susceptible to recurrent urinary tract infections, recurrent renal stones, and renal injury. Fusion of the kidney lower poles is relatively common compared to other types of renal anomalies.Case presentationWe present the case of a 36-year-old Sudanese female patient who presented with a long history of recurrent urinary tract infections unresponsive to antibiotics. Ultrasound scan revealed bilateral pelvic kidneys. Computed tomography (CT) urography confirmed bilateral ectopic fused kidneys, with the left kidney mal-rotated (renal pelvis facing upwards and laterally). Kidney infection secondary to vesicoureteral reflux was diagnosed. Antibiotics were prescribed according to culture and sensitivity. The patient responded well to ciprofloxacin.ConclusionA history of recurrent urinary tract infections without an apparent cause is highly suggestive of renal anomaly and should be investigated expediently. Ultrasonography or CT imaging may be utilized to aid in diagnosis. Early recognition may help prevent the high risk of end-stage renal failure associated with anomalies.

Highlights

ConclusionA history of recurrent urinary tract infections without an apparent cause is highly suggestive of renal anomaly and should be investigated expediently
The incidence of ectopic kidneys is 1:12,000 clinically and 1:900 postmortem
A history of recurrent urinary tract infections without an apparent cause is highly suggestive of renal anomaly and should be investigated expediently

Summary

Conclusion

Renal anomalies should be suspected in any adult patient with a recurrent history of urinary tract infections. Ultrasonography should be performed as an initial investigation for all patients with such a history. Detection of renal malformation is important to minimize the risk of developing stones, end-stage renal failure, and other renal disorders. Magnetic resonance urography is considered the optimal imaging technique in all age groups. This should be undertaken should abnormalities be detected on other imaging modalities, as it allows for better separation of renal poles and accurate calculation of renal function

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