Percutaneous nephrolithotripsy for renal pelvis stone in a crossed fused ectopic kidney: a case report
DOI:
https://doi.org/10.18203/2320-6012.ijrms20163823Keywords:
Crossed renal ectopia, Hematuria, Nephrolithiasis, Percutaneous nephroltihotripsyAbstract
Crossed renal ectopia is the second most common fusion anomaly of the kidney after horseshoe kidney. The incidence of both fused and unfused cases is 1 in 7000 in autopsies. Percutaneous nephrolithotripsy (PCNL) is a well-established technique in the surgical management of nephrolithiasis. The conventional fluoroscopic guidance of PCNL will be of limited value in ectopic anomalous kidneys due to the abnormal anatomical landmarks with consequent compromise of the procedure’s safety. A 30-year old male patient, previously healthy, presented to our urology outpatient clinic complaining of dull flank pain of six month duration with tenderness in the right renal area and an enlarged right kidney and 1 episode of gross haematuria. Radiological investigations showed left side crossed ectopia with nephrolithiasis. Patient was managed successfully by fluoroscopic guided percutaneous nephrolithotripsy. The position of the stone-containing ectopic kidney can make it easy to reach the pelvis of the target kidney without injuring any adjoining structure. The superimposition of the different soft tissue densities in the radiologic view may limit the ability of the operator to distinguish between different tissue identities. Laparoscopic guidance can represent as a practical solution to this technical problem.
References
Abeshouse BS, Bhisitkul I. Crossed renal ectopia with and without fusion. Urologia Internationalis. 1959;9(2):63-91.
Felzenberg J, Nasrallah PF. Crossed renal ectopia without fusion associated with hydronephrosis in an infant. Urology. 1991;38(5):450-2.
Sood R, Truong MX, Rossleigh MA, Kainer G. Renal scintigraphy unraveled the diagnostic dilemma of antenatal hydronephrotic solitary kidney-crossed renal ectopia. Clin Nuclear Med. 2005;30(9):621-2.
Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA. Campbell-Walsh Urology: Expert Consult Premium Edition: Enhanced Online Features and Print, 4-Volume Set. Elsevier Health Sciences; 2011.
McDonald JH, McClellan DS. Crossed renal ectopia. Am J Surg. 1957;93(6):995-1002.
Maizels M, Stephens FD. The induction of urologic malformations. Understanding the relationship of renal ectopia and congenital scoliosis. Investig Urol. 1979;17(3):209-17.
Rinat C, Farkas A, Frishberg Y. Familial inheritance of crossed fused renal ectopia. Pediatric Nephrol. 2001;16(3):269-70.
Hwang CM, Miller FH, Dalton DP, Hartz WH. Case report: Accidental ureteral ligation during an inguinal hernia repair of patient with crossed fused renal ectopia. Clin Imaging. 2002;26(5):306-8.
Kato M, Ioritani N, Aizawa M, Inaba Y, Watanabe R, Orikasa S. Extracorporeal shock wave lithotripsy for a ureteral stone in crossed fused renal ectopia. International J Urol. 2000;7(7):270-3.
Larre S, Carpentier X, Sebe P, Tassart M, Cussenot O, Traxer O. A report of unusual crossed fused renal ectopia and minimal invasive management of calculi. Surg Radiol Anatomy. 2007;29(5):393-5.
Nabi G, Kasana I, Khan M. Management of nephrolithiasis in crossed renal ectopia. J Postgrad Med. 2001;47(1):66.
Muttarak M, Peh WC, Lerttumnongtum P. Clinics in diagnostic imaging (59). Singapore Med J. 2001;42(3):139-41.
Matlaga BR, Kim SC, Watkins SL, Kuo RL, Munch LC, Lingeman JE. Percutaneous nephrolithotomy for ectopic kidneys: over, around, or through. Urology. 2006;67(3):513-7.
Edwan GMA, Mustafa M. Laparoscopic assisted percutaneous nephrolithotomy for renal pelvis stone in a crossed fused ectopic kidney: a case report. Jordan Med J. 2013;47(2):183-8.
