Pancake Kidney Research Articles

Anatomical and Histological Analyses of Rare Pancake Kidney

Anatomical and Histological Analyses of Rare Pancake Kidney

Pancake kidney – a rare form of renal malformation in a 7-year-old girl. A case report and a literature review

Renal ectopia and renal fusion belong to a group of congenital anomalies of the kidney and urinary tract that mostly remain asymptomatic and are diagnosed incidentally. Patients with congenital renal anomalies are prone to urinary tract infections and stone formation, and ultimately more likely to develop chronic kidney disease. Pancake kidney is one of the rarest types of renal anomaly, with complete fusion of the superior and inferior poles as well as the middle parts of both kidneys in the pelvic cavity into a pancake-like mass. Imaging studies play a key role in the diagnosis of this anomaly. We present a case of a girl diagnosed with pancake kidney at the age of 8 years. The patient did not present with any alarming symptoms and the suspicion of renal malformation was raised after an abdominal ultrasound, which shew that the left kidney was missing from its typical location. Ultimately, computed tomography allowed for precise imaging of the urinary tract and establishing the diagnosis.

Managing a large staghorn stone in a Doughnut kidney

Doughnut or Pancake kidney is a condition in which both the kidneys fused at the medial borders of each pole to produce a ring-shaped mass. In addition to nonspecific lower abdomen discomfort, pyrexia and haematuria, signs of a urinary tract infection may also be present in an otherwise asymptomatic pancake kidney. Sometimes the diagnosis is coincidental. However different imaging modalities like USG, MDCT, computed tomography (CT) urography, and radio nucleotide scanning are use confirmed the diagnosis. Different surgical options such as open pyelolithotomy, laparoscopic or robot assisted pyelolithotomy can be consumed to treat such patient, however the literature proposes that an open pyelolithotomy is a safer and more rational approach to avoid injury to any aberrant vessels which are more common in such cases. KeyWord: Doughnut Kidney, Renal Stone, Pyelolithotomy

Rare bird spotted: renal clear cell carcinoma in a pancake kidney case report

The discovery of a tumor process on a Pancake kidney allows the authors to review both the particularities of this association and the diagnostic and therapeutic difficulties. The diagnosis of Pancake kidney may be difficult, and CT Scan examination is very useful to confirm the renal anomaly, tumor situation, and to plan a surgical strategy by visualizing the vascular pedicles which are highly variable. The surgery of exeresis, adapted to the tumor location, represents the essential therapeutic time.

Unveiling the confusion in renal fusion anomalies: role of imaging.

Renal fusion anomalies are common congenital anomalies of the urogenital tract and have their genesis in the early embryonic period. They are classified into partial fusion anomalies (e.g., crossed fused ectopia, and horseshoe kidney) and complete fusion anomalies (e.g., fused pelvic kidney). Horseshoe kidney is the most common renal fusion anomaly and is characterized by the presence of two distinct functioning kidneys on either side of the vertebral column, with fusion occurring at the inferior poles in majority of the cases. Crossed fused ectopia is characterized by the presence of an ectopic kidney that crosses the midline and fuses with the orthotopic contralateral kidney, whereas fused pelvic (pancake) kidney is a complete fusion anomaly characterized by extensive medial fusion of both kidneys in the pelvis. Fusion anomalies are often associated with abnormalities of renal rotation, migration, and vascular supply, which predispose the kidneys to a number of complications and create difficulty during retroperitoneal surgeries and interventions. They are also associated with other congenital abnormalities of the urogenital tract, gastrointestinal tract, cardiovascular system, and skeletal system. Hence, a thorough understanding of the etiopathogenesis and radiological features of fusion anomalies is important for directing patient management. This review summarizes the embryological basis, clinical presentation and imaging approach to renal fusion anomalies, followed by detailed anatomical and radiological description of the morphological types, and the complications associated with these anomalies.

Congenital Anomalies of the Upper Urinary Tract: A Comprehensive Review.

The upper urinary tract is the most common human system affected by congenital anomalies. Congenital anomalies of the kidneys and ureters comprise a wide spectrum of disorders ranging from simple variants with no clinical significance to complex anomalies that may lead to severe complications and end-stage renal disease. They may be classified as anomalies of renal form, which are subclassified as structural anomalies (eg, persistent fetal lobulation, hypertrophied column of Bertin, and dromedary hump) and fusion anomalies (eg, horseshoe kidney and pancake kidney); anomalies of renal position (eg, renal malrotation, simple renal ectopia, and crossed renal ectopia) and renal number (eg, renal agenesis and supernumerary kidney); and abnormalities in development of the urinary collecting system (eg, pyelocaliceal diverticulum, megacalycosis, ureteropelvic junction obstruction, duplex collecting system, megaureter, ectopic ureter, and ureterocele). US is usually the first imaging modality used because of its low cost, wide availability, and absence of ionizing radiation. Intravenous urography and voiding cystourethrography are also useful, mainly for characterization of the collecting system and vesicoureteral reflux. However, intravenous urography has been replaced by CT urography and MR urography. These imaging methods not only allow direct visualization of the collecting system but also demonstrate the function of the kidneys, the vascular anatomy, adjacent structures, and complications. Comprehension of congenital anomalies of the upper urinary tract is crucial for an accurate diagnosis and correct management. The authors discuss the spectrum of these anomalies, with emphasis on embryologic development, imaging findings, clinical manifestations, and complications. Online supplemental material is available for this article. ©RSNA, 2021.

Pancake Kidney, Rare Kidney Fusion Anomaly in Pediatrics

Pancake or doughnut kidney is a very rare anatomical abnormality. It is subgroup of fusion anomaly. Most of the time, diagnosed incidentally because affected patients are asymptomatic. Here we repot Pancake kidney in Toddler boy with proteinuria and developmental delay.

Incidentally detected pancake kidney: a case report

BackgroundCongenital anomalies of the urinary system are very common and have extremely varied presentation. Among them, the most rarely found structural anomaly is the pancake kidney. When both kidneys are fused along their medial surfaces to form a round-shaped single renal mass, it is termed as pancake kidney. In this case report, a pancake kidney was incidentally detected in a girl. The majority of individuals who have pancake kidney are usually asymptomatic but surgeons should be aware of coexisting malformation of other organs and its potential risk of developing malignancy.Case presentationA 12-year-old Bengali girl presented to our out-patient department with mild, dull aching, lower abdominal pain and dysuria. She had no history of fever, hematuria, menstrual abnormality, pelvic inflammatory disease, or trauma. Urine examination showed traces of albumin and 10–12 pus cells/high-power field. She had normal kidney function test but a digital X-ray of her kidney, ureter, and bladder region failed to demonstrate bilateral renal tissue shadows. Ultrasonography of her whole abdomen showed normal intra-abdominal organs except for empty bilateral renal fossa. A multi-detector computed tomography scan of her whole abdomen revealed one round-shaped mass measuring approximately 9 cm (vertical) × 10 cm (horizontal) in the pelvic cavity. That mass was finally identified as a pancake kidney. She was prescribed antibiotics based on urine culture and sensitivity test that cured her symptoms. She was advised to follow-up regularly in our out-patient department to evaluate her kidney function and to rule out any neoplastic change.ConclusionsThis condition can be managed conservatively, if the individual remains asymptomatic, by regular monitoring of renal function. Surgeons should remain alert for the development of infections, any obstructive manifestations leading to calculus formation, and any malignant changes. The individual should be careful in avoiding trauma to low-lying pelvic kidney. Extensive surgeries should be avoided and only selective procedures should be done so that the patient may lead a normal lifestyle.

Pancake kidney with single draining ureter: a rare developmental anomaly

Pancake kidney is one of rare form of congenital developmental anomaly of kidney. Very rarely it is drained by a single ureter. We are reporting a case of pancake kidney with a single draining ureter. The diagnosis was made during the routine workup for abdominal pain and UTI in a 12 year old male child. Usually pancake kidney may be associated with other congenital malformation but in our case we did not find any. Pancake kidney is managed surgically as well as conservatively depending upon the presenting symptoms and problem. This case was managed conservatively for recurrent UTI.

Fetal Pancake Kidney

Bilateral failure of the kidneys to ascend during embryonic life may lead to fusion of the two renal masses, resulting in a round mass known as pancake kidney. Reviewing the literature, we did not encounter any reports of prenatal diagnosis of pancake kidneys. We present 6 cases of a pancake kidney diagnosed prenatally. Extrarenal associated anomalies included an aberrant right subclavian artery, nonvisualization of the uterus, consistent with Mayer-Rokitansky-Küster-Hauser syndrome, and a sequence of early-onset growth restriction, hypospadias, and syndactyly, suspected as Smith-Lemli-Opitz syndrome. On postnatal follow-up, all infants had a normal renal outcome.

A rare congenital fusion anomaly of the urinary tract: Pancake kidney.

Pancake kidney is a rare subtype of cross fused renal ectopia. Fusion of both upper and lower poles of the kidney in pelvis results in a disc or cake shaped kidney appearence. In this report, we are presenting two cases (a 3-month-old male and a 3-year-old girl) with different presentations and their follow-up results. Usually, renal fusion anomalies do not pose a risk for deterioration of renal function. With this fact kept in mind, cases should be managed individually. Additionally, magnetic resonance imaging should be the preferred modality in which further evaluation is required since it can give both functional and anatomical detail with no radiation exposure.

OP06.04: Fetal pancake kidney: prenatal diagnosis and postnatal follow‐up

OP06.04: Fetal pancake kidney: prenatal diagnosis and postnatal follow‐up

Pancake kidney: An unusual type of renal fusion anomaly found in 99mTc-DMSA renal scintigraphy

A 2.5-year-old boy with a history of the previous incidental finding of an ectopic kidney in ultrasonography was referred to our nuclear medicine center for 99mTc-DMSA renal scintigraphy. The scan showed an unusual type of ectopic fused kidneys on the right side of the lower abdomen. In this anomaly, kidneys were fused completely across the medial portion of both upper and lower poles, as well as hilum with no septum. Each kidney, however, demonstrated separate consists of own collecting system. 99mTc-DMSA renal scintigraphy is a valuable imaging detection of different shape anomalies such as pancake kidney. We report this extremely rare case of ectopic fused types of renal anomaly including pancake kidney

Use of Hypothermic Machine Perfusion to Identify Anatomic Variation Before Transplantation of a Pancake Kidney: A Case Report.

Author(s): Galganski, Laura A; Perez, Richard V; Troppmann, Christoph; McVicar, John P; Santhanakrishnan, Chandrasekar; Mortimer, Bradley; Kelly, Beau; Sageshima, Junichiro

OBSTRUCTED PAN CAKE KIDNEY IN A CHILD MANAGED BY IMAGE GUIDED PERCUTANEOUS NEPHROSTOMY

Pancake kidney, also called pelvic fused kidney, lump or cake kidney, is a rare type of congenital renal fusion anomaly. It is characterized by the presence of a lobulated pelvic renal mass which has a dual parenchymatous system without an intervening septum. Pancake kidney is prone to obstruction due to abnormal rotation of collecting system and calculus. When a patient presents with a nonfunctioning and obstructed kidney, a temporary nephrostomy preserves any recoverable renal tissue. Many a times a seemingly alarming radiological appearance where little functional recovery is expected, dramatic improvement in renal function has been noticed. We report a case of pancake kidney with right PUJ and left ureteric calculus causing hydronephrosis in a 9-years-old male child, evaluated by ultrasonography and MDCT, underwent image guided (sonography and fluoroscopy) percutaneous nephrostomy for relieving the ureteric obstruction.
 Keywords: Renal fusion, pancake kidney, percutaneous nephrostomy, nephrostogram.

The pancake kidney.

The pancake kidney.

Pancake kidney: when it is not a problem.

Pancake kidney is a very rare congenital anomaly involving complete fusion of medial renal parenchyma. The interface is devoid of any intervening septum. As described, the kidneys form a single lobulated mass in pelvic location. However, dual collecting systems are retained, and the shortened, anteriorly seated ureters enter the bladder normally. This condition is usually discovered incidentally but may confer a heightened susceptibility to recurrent urinary tract infections or stone formation, given the likelihood of anomalous collecting system rotation and the potential for ureteral stasis or obstruction. Excretory urography, the customary method of detection, has been replaced by ultrasonography, CT, MRI, and radionucleotide scanning. Herein, we present a male patient with a pelvic pancake kidney, never symptomatic. A conservative approach of regular follow up visits and laboratory testing was elected, thus avoiding any unnecessary investigations or extensive surgery.

Pancake Kidney in 99mTc-DMSA Study (Case Report)

Pancake kidney, also known as discoid kidney, lump kidney, or fused pelvic kidney, is a rare renal fusion anomaly of the kidneys of the crossed fused variety. The majority of patients with this anomaly are asymptomatic. We present a case of pancake kidney which was incidentally found in a child with abdominal pain with no other associated anomalies and was managed conservatively.

Pancake Kidney: A Rare Case Report Developmental Anomaly in Child

The aim of the study is to present a rare case of incidentally detected pelvic pancake kidney with radiological imaging findings in a 11 year old male child. There are many developmental anomalies of kidney Various types of congenital renal abnormalities such as renal agenesis, ectopic or horseshoe kidney can be encountered where one of the most rarest presentation with a single ureter on pancake kidney is encountered in number that count in fingers worldwide.Med Phoenix Vol.2(1) July 2017, 71-73

Stone in Ectopic Pelvic Pancake Kidney: A Surgical Challenge

Clinical Image: A 40 years old without a specific history who presents hypogastric pain associated with urinary signs type dysuria, pollakiuria. Biologically renal impairment with creatinine at 45 mg/l/min, ECBU is negative. Radiologically, abdominal ultrasound objective absence of visualization of the two kidneys with a pelvic renal ectopia is the seat of multiple stones, supplemented by an abdominal CT without injection of contrast product which confirms the presence of a dilation. Kidney laminating the parenchyma on a pancake lithiasic pelvic kidney driving back the bladder in the anterior. After discussion with the patient, an exploratory umbilical laparotomy with possibly nephorolithotomy for the extraction of the stones was proposed but the patient refused the procedure. Pancake kidney is rare and usually asymptomatic. Surgical intervention may be needed at complicated cases. Careful preoperative scrutiny of imaging can guide surgical therapy. More research is needed to establish the standard management of these patients.