Discharging loin sinus: Unusual manifestation of ruptured horseshoe kidney

Tropical Doctor ◽

10.1177/00494755211023247 ◽

2021 ◽

pp. 004947552110232

Author(s):

Debajyoti Mohanty ◽

Niraj Kumar Srivastava ◽

Nitin Bhajandas Borkar

Keyword(s):

Interstitial Nephritis ◽

Surgical Procedure ◽

Horseshoe Kidney ◽

Renal Stones ◽

Renal Pathology ◽

Fistula Tract ◽

Unusual Manifestation ◽

Chronic Interstitial Nephritis ◽

Left Hemi

We present a 20-year-old man with a chronic discharging sinus in the left loin arising from a horseshoe kidney with a large pelvicalyceal calculus on its left side. The left moiety was non-functional, so a left hemi-nephrectomy, together with excision of the whole fistula tract, was carried out. Histopathology was suggestive of chronic interstitial nephritis. Patients with horseshoe kidney are prone to development of renal stones and their associated complications. The unfamiliar anatomy of horseshoe kidneys may increase the complexity of any surgical procedure. Radiological investigations are pivotal in identification of the underlying renal pathology; they may also delineate a fistula tract as in our case.

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AJKD Atlas of Renal Pathology: Chronic Interstitial Nephritis

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2017.05.002 ◽

2017 ◽

Vol 70 (1) ◽

pp. e1-e2

Author(s):

Agnes B. Fogo ◽

Mark A. Lusco ◽

Behzad Najafian ◽

Charles E. Alpers

Keyword(s):

Interstitial Nephritis ◽

Renal Pathology ◽

Chronic Interstitial Nephritis

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Spontaneous Glomerulonephritis in Dogs: II. Correlation of Glomerulonephritis with Age, Chronic Interstitial Nephritis and Extrarenal Lesions

Veterinary Pathology ◽

10.1177/030098587701400204 ◽

1977 ◽

Vol 14 (2) ◽

pp. 121-127 ◽

Cited By ~ 32

Author(s):

R. Müller-Peddinghaus ◽

G. Trautwein

Keyword(s):

Interstitial Nephritis ◽

Membranoproliferative Glomerulonephritis ◽

Age Groups ◽

Renal Amyloidosis ◽

Morphologic Study ◽

Different Types ◽

End Stage ◽

Chronic Interstitial Nephritis ◽

Slight Damage ◽

Severe Fibrosis

A morphologic study of 103 dogs, including two with renal amyloidosis, showed that different types of diffuse glomerulonephritis are correlated with different age groups. Membranous and membranoproliferative glomerulonephritis were more common in middle-aged and older animals, whereas mesangial lesions were found predominantly in younger dogs and considered to be early glomerular changes. Glomerulonephritis largely occurred independently of interstitial nephritis. The incidence of interstitial lesions was 71%. Chronic interstitial nephritis was rare in dogs under 1 year old. Glomerulonephritis did not seem to induce interstitial nephritis. Glomerulonephritis occurred not only in kidneys with severe interstitial damage, but also in those with slight damage. This indicated that glomerulonephritis occurred independently of interstitial nephritis. In end-stage kidneys with severe fibrosis, mesangial changes seemed to predominate.

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Comparison between different techniques for management of renal stones in horseshoe kidneys

QJM ◽

10.1093/qjmed/hcab110.001 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Abdel Fattah Mohammed Aggour ◽

Mohamed Kotb Ahmed Tolba ◽

Abdelrahman nazmy abbas hatata

Keyword(s):

Horseshoe Kidney ◽

Renal Stones ◽

Operative Management ◽

Flexible Ureteroscopy ◽

Stone Clearance ◽

Stone Burden ◽

Laparoscopic Pyelolithotomy ◽

Almost All ◽

Laparoscopic Assisted ◽

Operating Surgeon

Abstract Objective To report the operative management , intra and post operative complications and subsequent stone-free rates of patients with urolithiasis in a horseshoe kidneys. Materials and Methods We retrospectively reviewed all patients presenting to our centre with a horseshoe kidney and urolithiasis over a 20-year period. The stone burden, surgical management, complications and stone clearance rates were recorded. Results In all, 80 patients with urolithiasis in horseshoe kidney were treated. Percutaneous nephrolithotomy (PCNL) was used in 28 patients. 12 patients had laparoscopic assisted PCNL , 8 had flexible ureteroscopy and 18 had laparoscopic pyelolithotomy . PCNL was used for large stones = (mean digitized surface area= 614.32 mm 2 ) and required one to four stages to achieve an overall stone clearance rate of 88%. Stones were cleared at one sitting in 77% of PCNL procedures. only 33% of patients treated with flexible ureteroscopy was cleared from stones in one session and surprisingly, 89% of patients treated with laparoscopic pyelolithotomy was stone free after one session Complications were minimal, with 15% minor and 3% major complications in the PCNL group only.. Conclusions Appropriate management of urolithiasis within the horseshoe kidney depends not only on stone burden, but also on stone location, calyceal configuration and malrotation. Stones can be cleared successfully in almost all patients providing that all techniques are available to the operating surgeon.

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