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Images in clinical medicine

Horseshoe kidneys

Horseshoe kidneys

Asaad El Bakkari1,&, Najwa Ech-Chrif El Kettani1

 

1Neuroradiology Department Head and Neck Hospital of Rabat, Rabat, Morocco

 

 

&Corresponding author
Asaad El Bakkari, Neuroradiology Department Head and Neck Hospital of Rabat, Rabat, Morocco

 

 

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Our case is about a 38 year old male who consulted in emergency for a car accident with severe head trauma. In front of that we realized a body CT, the abdominal images finds a renal tissue of normal imaging appearance, but with both renal lower poles pointing medially and fused across the midline by an isthmus of functioning renal tissue characteristic of horseshoe kidneys (HSK) (A), the ureters arise from the kidneys anterior rather than medially. HSK is one of the most common renal fusion anomalies with a prevalence of 0.25% among the general population. He can be isolated in 30% of cases, but most frequently he is associated with panoply of genitourinary and non-genitourinary malformations, and he is also seen as part of a number of syndromes anomalies. The most commonly associated are ureteropelvic junction obstruction, lithiasis and renal infections with a higher risk of renal traumatic lesion and increased incidence of certain renal malignancies. Clinically HSK are mostly asymptomatic, they are however prone to a number of complications as a result of poor drainage, which may lead to clinical presentation. The diagnosis essentially is made by the CT he contribute also to the evaluation of urinary tract anatomy and pathologies associated.

 

 

Figure 1: axial CT section (A) and coronal CT section (B) shows a renal tissue of normal imaging appearance, but with both renal lower poles pointing medially and fused across the midline by an isthmus characteristic of horseshoe kidneys