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Virtual Pediatric Hospital: Paediapaedia: Horseshoe Kidney Paediapaedia: Genitourinary Diseases

Horseshoe Kidney

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


Clinical Presentation:
Some have symptoms in infancy or early childhood of urinary tract infection or obstruction. An abdominal mass may be palpable.

Etiology/Pathophysiology:
Due to abnormal ascent of the kidneys. The renal fusion is across the midline, usually between the lower poles, and the fusion can be parenchymal or fibrous tissue.Due to the exposed position of the kidney the patient is at greater risk for renal injury after blunt trauma. There is an increased incidence of Wilms tumor, and in later life of adenocarcinoma. Fifty percent of patients have other genitourinary anomalies - collecting system duplication, cryptorchism, and urethral anomalies.

Pathology:
Not applicable

Imaging Findings:
The kidney is normally lower than usual because of incomplete ascent and their lower poles are more medial than the upper poles. The lower pole calyces and renal pelves are located anteriorly with the ureters located in front of the pelves and coursing over the fused isthmus.

DDX:

References:
See References Chapter.

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