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   Caption        = Renal scan image demonstrates cross-fused renal ectopia. <br> [http://www.radswiki.net Image courtesy of RadsWiki]|
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{{Renal ectopia}}
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{{CMG}}; {{AE}}:  [[User:zorkun|Cafer Zorkun]] M.D., PhD.


'''Renal ectopia''' or ''ectopic kidney'' describes a [[kidney]] that is not located in its usual position. 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.  
'''Editor:''' [https://www.wikidoc.org/index.php?title=L.Farrukh&action=edit&redlink=1 L.Farrukh]


==Crossed-fused renal ectopia==
{{SK}} Ectopic kidney


* Crossed ectopy = kidney located on the opposite side of the midline from its ureter.
==[[Renal ectopia overview|Overview]]==
* In 90% of crossed ectopy, there is at least partial fusion of the kidneys (the remainder demonstrate two discrete kidneys on the same side, crossed-unfused ectopy)
Renal ectopia is defined as an atypically placed kidney due to faulty migration from the fetal pelvis during embryologic development. Ectopic kidney may be abdominal, lumbar or pelvic, based on its position in the retroperitoneum. It can be placed either ipsilaterally or contralaterally, when it is called crossed renal ectopia.
* Due to improper renal ascent in embryogenesis (4th-8th week of fetal life - normally, the kidney reaches its appropriate position at L2 level at the end of the 2nd month)
 
* Fusion of the kidneys within the pelvis leads to crossed-fused renal ectopia.
==[[Renal ectopia historical perspective|Historical Perspective]]==
* Abnormally situated umbilical artery prevents normal cephalic migration. Another theory is that the ureteric bud crosses to the opposite side and induces nephron formation in the contralateral metanephric blastema.
 
==[[Renal ectopia classification|Classification]]==
 
==[[Renal ectopia pathophysiology|Pathophysiology]]==
 
==[[Renal ectopia causes|Causes]]==
 
==[[Renal ectopia differential diagnosis|Differentiating Renal ectopia from other Diseases]]==
 
==[[Renal ectopia epidemiology and demographics|Epidemiology and Demographics]]==
 
==[[Renal ectopia risk factors|Risk Factors]]==
 
==[[Renal ectopia screening|Screening]]==
 
==[[Renal ectopia natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
 
==Diagnosis==
[[Renal ectopia diagnostic study of choice|Diagnostic Study of Choice]] | [[Renal ectopia history and symptoms|History and Symptoms]] | [[Renal ectopia physical examination|Physical Examination]] | [[Renal ectopia laboratory findings|Laboratory Findings]] | [[Renal ectopia electrocardiogram|Electrocardiogram]] | [[Renal ectopia x ray|X Ray]] | [[Renal ectopia CT|CT]] | [[Renal ectopia mri|MRI]] | [[Renal ectopia ultrasound|Ultrasound]] | [[Renal ectopia other imaging findings|Other Imaging Findings]] | [[Renal ectopia other diagnostic studies|Other Diagnostic Studies]]
 
==Treatment==
[[Renal ectopia medical therapy|Medical Therapy]] | [[Renal ectopia surgery|Surgery]] | [[Renal ectopia primary prevention|Primary Prevention]] | [[Renal ectopia secondary prevention|Secondary Prevention]] | [[Renal ectopia cost-effectiveness of therapy| Cost-Effectiveness of Therapy]] | [[Renal ectopia future or investigational therapies|Future or Investigational Therapies]]
 
==Case Studies==
[[Renal ectopia case study one|Case #1]]
 
'''Presentation :'''
 
A 28–year-old male presented with recurrent pain in his lower left abdomen present for one month and an episode of hematuria 3 days earlier, accompanied by an attack of acute pain lasting for 3–4 hours. He gave a history of passing 2 small (about 5 mm each) calculi in his urine after the occurrence of hematuria, following which pain decreased in intensity. No history of fever was present.
 
'''Investigations and Findings :'''
 
*Routine blood tests were normal except for erythrocyte sedimentation rate which was slightly raised (38 mm/hr, Westergren method).
*Urine was sterile and serum creatinine and urea were within normal limits.
*The kidneys/ureter/bladder x-ray was unremarkable.
*An emergency ultrasound scan of the abdomen was reported as non-visualization of the left kidney in the left renal region, or elsewhere in the abdomen.
*During scan of the urinary bladder which was normal in outline a jet of urine was seen emerging from the left uretero-vesical junction which was confirmed on color Doppler examination. These sonographic findings led to the impression of an ectopically located left kidney.
*Subsequently, an IVP (intravenous pyelogram) was requested. It revealed that the left kidney was not located in its normal anatomical position and was instead found at the level of L4, L5 and S1 vertebrae, slightly to the left of the midline
*It was smaller compared to the right kidney, measuring 10 cm vertically, 7 cm transversally, and 3.5 cm in thickness (right kidney measured 14×10×4.5 cm). This ectopic kidney was slightly malrotated with its pelvis oriented anteromedially. The long axis passed inferiomedially. It showed normal excretion on IVP.
*The right kidney was normal in size, site and function. No calculus or hydronephrosis was seen. Both ureters were normal with contrast opacification and were opening into the bladder. The left ureter was, however, shorter in its course. The urinary bladder showed normal contrast opacification and on emptying, no significant residual urine was seen.
 
'''Results :'''
 
As the patient did not present with any other complaint, he was discharged with the advice of follow-up ultrasound scans and to report back in case of similar complaints in future.


{{Congenital malformations of genital organs and urinary system}}
{{Congenital malformations of genital organs and urinary system}}
{{SIB}}


[[Category:Nephrology]]
[[Category:Nephrology]]
 
[[Category:Disease]]
{{WH}}
{{WH}}
{{WS}}
{{WS}}

Latest revision as of 15:15, 6 September 2020

Renal ectopia
Renal scan image demonstrates cross-fused renal ectopia.
Image courtesy of RadsWiki
ICD-10 Q63.2
ICD-9 753.3

Renal ectopia Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Renal ectopia from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: : Cafer Zorkun M.D., PhD.

Editor: L.Farrukh

Synonyms and keywords: Ectopic kidney

Overview

Renal ectopia is defined as an atypically placed kidney due to faulty migration from the fetal pelvis during embryologic development. Ectopic kidney may be abdominal, lumbar or pelvic, based on its position in the retroperitoneum. It can be placed either ipsilaterally or contralaterally, when it is called crossed renal ectopia.

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Renal ectopia from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X Ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Presentation :

A 28–year-old male presented with recurrent pain in his lower left abdomen present for one month and an episode of hematuria 3 days earlier, accompanied by an attack of acute pain lasting for 3–4 hours. He gave a history of passing 2 small (about 5 mm each) calculi in his urine after the occurrence of hematuria, following which pain decreased in intensity. No history of fever was present.

Investigations and Findings :

  • Routine blood tests were normal except for erythrocyte sedimentation rate which was slightly raised (38 mm/hr, Westergren method).
  • Urine was sterile and serum creatinine and urea were within normal limits.
  • The kidneys/ureter/bladder x-ray was unremarkable.
  • An emergency ultrasound scan of the abdomen was reported as non-visualization of the left kidney in the left renal region, or elsewhere in the abdomen.
  • During scan of the urinary bladder which was normal in outline a jet of urine was seen emerging from the left uretero-vesical junction which was confirmed on color Doppler examination. These sonographic findings led to the impression of an ectopically located left kidney.
  • Subsequently, an IVP (intravenous pyelogram) was requested. It revealed that the left kidney was not located in its normal anatomical position and was instead found at the level of L4, L5 and S1 vertebrae, slightly to the left of the midline
  • It was smaller compared to the right kidney, measuring 10 cm vertically, 7 cm transversally, and 3.5 cm in thickness (right kidney measured 14×10×4.5 cm). This ectopic kidney was slightly malrotated with its pelvis oriented anteromedially. The long axis passed inferiomedially. It showed normal excretion on IVP.
  • The right kidney was normal in size, site and function. No calculus or hydronephrosis was seen. Both ureters were normal with contrast opacification and were opening into the bladder. The left ureter was, however, shorter in its course. The urinary bladder showed normal contrast opacification and on emptying, no significant residual urine was seen.

Results :

As the patient did not present with any other complaint, he was discharged with the advice of follow-up ultrasound scans and to report back in case of similar complaints in future.

Template:WH Template:WS