article · Journal of Medical Case Reports
Horseshoe kidney is a renal fusion anomaly affecting roughly one in 500 individuals globally, characterised by altered renal position, rotation, and blood supply. Although frequently asymptomatic, it can cause urological issues from impaired urinary drainage and ureteric obstruction. Ureteropelvic junction obstruction is an uncommon complication in these kidneys that creates distinct diagnostic and surgical challenges. A case report outlines a three-month-old male infant who presented with prolonged crying and abdominal distension. Diagnostic imaging identified a horseshoe kidney featuring left renal parenchymal thinning and severe hydronephrosis ending abruptly at the left ureteropelvic junction. Successful surgical correction was carried out. Over a six-month follow-up period, the infant remained symptom-free with normal renal function. The findings highlight the importance of detailed imaging and meticulously planned pyeloplasty to successfully relieve obstruction in patients with these complex anatomical variations.
Horseshoe kidney is a common congenital condition that can lead to severe complications if urinary flow is obstructed. Recognising how to diagnose and surgically correct uncommon blockages in these abnormally shaped organs helps surgeons protect infant kidney function and prevent long-term renal damage through timely, tailored interventions.
The abstract does not indicate an application pathway, as it reports a clinical case and standard surgical management rather than a commercial product or technology.
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BACKGROUND: Horseshoe kidney is the most common renal fusion anomaly, occurring in approximately 1 in 500 individuals worldwide. It is characterized by abnormalities in kidney position, rotation, and vascular supply. While often asymptomatic, horseshoe kidneys can lead to urological complications, primarily due to ureteric obstruction and impaired urinary drainage.Although ureteropelvic junction obstruction (UPJO) is uncommon in horseshoe kidneys, its occurrence presents unique diagnostic and management challenges. This case explores the etiology, clinical presentation, and surgical management of UPJO in a patient with a horseshoe kidney, highlighting the critical role of urologists in addressing these anatomical and functional complexities. CASE PRESENTATION: We report the case of a 3-month-old African male infant who presented with a two-month history of excessive crying and symmetrical abdominal distension. Radiological evaluation revealed a horseshoe kidney with decreased parenchymal thickness in the left kidney and marked hydronephrosis of the pelvis and calyces, with abrupt cessation at the left ureteropelvic junction. Surgical correction of the obstruction was performed successfully. The patient was followed for six months, during which he remained symptom-free with normal renal function tests. CONCLUSION: Ureteropelvic junction obstruction in a horseshoe kidney presents unique anatomical challenges. Symptomatic cases require thorough imaging for diagnosis and surgical planning. Pyeloplasty is the typical surgical intervention, meticulously planned to address these complexities. This ensures effective relief of obstructions and proper urinary drainage.
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DOI: 10.1186/s13256-024-04981-7
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