A 64-slice CT angiographic study of morphologic and morphometric analysis of healthy kidney donors

The kidneys are bilaterally paired organs and serve several essential functions required to maintain a normal human physiological function. The renal size was conventionally determined on x-ray or urography by measuring the renal length distance of first lumbar vertebrae to third or fourth lumbar vertebrae. Ectopic position of the kidney can be associated with ureteric stone, vesicoureteric reflux and can predispose to iatrogenic trauma during interventional radiological and laparoscopic procedures and any surgeries. Therefore, it is important to know the variations between individuals in the level of kidney relative to the spinal column. The study aimed to analyse the morphometric and morphologic measurements of the kidney using CT angiogram in kidney donors. In this study, the length and breadth of kidney and different level of location of kidney in 100 renal donors were analysed. The study was conducted in specialised scan centres located in Chennai. Out of 100 kidney donors, 61% of them were male & 39% of them were female. The right kidney length was found to be 10.59 ±1.14 cms, and left kidney length was found to be 10.72 ± 1.22 cms. This report will be useful for transplant surgeries, as well as clinicians and radiologist who perform various techniques.

Download Full-text

Sonographic Assessment of Renal Length of Adults in Lagos, Nigeria

Nepalese Medical Journal ◽

10.3126/nmj.v2i2.25982 ◽

2019 ◽

Vol 2 (2) ◽

pp. 255-258

Author(s):

Ese Anibor

Keyword(s):

Imaging Modality ◽

Statistical Significance ◽

Left Kidney ◽

Radiology Department ◽

P Value ◽

Cluster Sampling ◽

Cross Sectional ◽

Kidney Length ◽

The Right ◽

Renal Length

Introduction: Ultrasound is an important imaging modality used in the prognosis and diagnosis of renal conditions and diseases and also in the evaluation of kidney donors. This study aimed at providing a reference for the normal metric variables of the kidney such kidney lengths of healthy Nigerian adults in Lagos State and to compare with previously obtained results.Materials and Methods: This study was conducted in the radiology department of Ikorodu Hospital. This study adopted a descriptive cross-sectional study design with a cluster sampling approach which consisted of 150 adults (with 300 kidneys) participants ages 18-87 years. Real-time gray-scale ultrasonic scanning using Prosound 3500 Aloka device and a 3.5–5 MHz curvilinear explorer was employed for the abdominal imaging. The data acquired were compiled and explored via the Statistical Package for the Social Sciences (SPSS) version 20. The student’s t-test was utilized in probing for statistical significance between age as well as gender in relation to renal length. P-value < 0.05 was adjudged to be significant.Results: The kidney length was of a greater distance in males, and the length of the left kidney was more extensive than that of the right kidney in both sexes. Average kidney length was greater on the left when compared to the right among the various age groups. No significant association was noted between kidney length and age as well as gender.Conclusions: Normal values for kidney length and diversifications in the kidney length of healthy adults in Nigeria have been established.

Download Full-text

A Case of Parasitic Twinning or Caudal Duplication in a Dog

Journal of the American Animal Hospital Association ◽

10.5326/jaaha-ms-6559 ◽

2018 ◽

Vol 54 (4) ◽

pp. 219-225

Author(s):

Janet A. Grimes ◽

Adrien-Maxence Hespel ◽

Robert C. Cole ◽

A. Ray Dillon

Keyword(s):

Soft Tissue ◽

Left Kidney ◽

Spinal Column ◽

Abdominal Ultrasound ◽

Colonic Diverticulum ◽

Hind Limbs ◽

History Of ◽

Soft Tissue Masses ◽

The Right ◽

Caudal Duplication

ABSTRACT A 6 mo old 13.5 kg (29.7 lb) male intact American Staffordshire terrier was evaluated for a history of supernumerary pelvic limbs, with malodorous discharge from a supernumerary penis. Imaging (radiographs, abdominal ultrasound, and computed tomography with excretory urogram) showed a supernumerary pelvis with associated pelvic limbs, no osseous continuity with the primary spinal column, a colonic diverticulum extending to the supernumerary pelvis, an enlarged left kidney with a ureter connecting to a single bladder, right renal aplasia, a single descended testicle in the primary scrotum, an intra-abdominal cryptorchid testicle, and two unidentifiable soft tissue masses. At surgery, a single ileum was present with a primary and accessory cecum and colon and the accessory colon entering the supernumerary pelvis. The accessory cecum and colon, right kidney, two unknown soft tissue masses, and the single descended testicle were removed. The right kidney had a ureter that anastomosed with the accessory colon at its entry into the supernumerary pelvis. The supernumerary pelvis and hind limbs were not removed. Five months after surgery, the dog was reported to be doing well clinically. Caudal duplication is extremely rare in veterinary medicine. The appearance of supernumerary external structures may indicate internal connections as well.

Download Full-text

Ectopic lumbar kidney: a rare presentation

International Surgery Journal ◽

10.18203/2349-2902.isj20184099 ◽

2018 ◽

Vol 5 (10) ◽

pp. 3410

Author(s):

Ela Haider Rizvi ◽

Kailash Charokar ◽

Ajay Kumar Jain

Keyword(s):

Abdominal Pain ◽

Left Kidney ◽

Lumbar Vertebrae ◽

Lower Abdominal Pain ◽

Symptomatic Therapy ◽

Ectopic Kidney ◽

Lower Abdomen ◽

Rare Presentation ◽

Lower Quadrant ◽

The Right

Ectopic kidney is a rare developmental anomaly. Such kidneys may be asymptomatic or present with vague symptoms or remain unknown during the lifetime. Early detection and recognition of an ectopic kidney can prevent long-term complications. We report a 70-year-old lady with ectopic right kidney who presented with intermittent episodes of lower abdominal pain since one month 1 month. On clinical evaluation a tender lump was palpable in the right lower quadrant of the abdomen. Sonography revealed empty right renal fossa with normally present left kidney. A mass was detected in the right lower abdomen, with probability of ectopic kidney. Further, Multislice computed tomography with 3-D reconstruction demonstrated ectopic right kidney at the level of L4 to L5 lumbar vertebrae. Urine examination revealed pyuria. The patient was managed on empirical antibiotics for UTI with supportive and symptomatic therapy. On the next day, clinically the lump regressed significantly (Dietl's crises) in size, and the tenderness also reduced. The urine culture report grew Escherichia coli. Patients presenting with lower abdominal pain, and a palpable lump in the lower abdomen, one must include ectopic kidney in the differential diagnosis.

Download Full-text

Aspects of Kidneys Morphometry

ARS Medica Tomitana ◽

10.2478/arsm-2018-0039 ◽

2018 ◽

Vol 24 (4) ◽

pp. 190-194

Author(s):

Bucur Alina Ana-Maria ◽

Bordei Petru ◽

Ispas Viorel

Keyword(s):

Left Kidney ◽

Renal Pathology ◽

General Electric ◽

Kidney Length ◽

The Right

Abstract Our results were obtained by examining subjects without renal pathology, aged 26-83 on a General Electric - Voluson 730 Expert ultrasound. The left kidney length was found between 56.98-122.90 mm, for female being 56.98-110.60 mm, and for male 84.73-122.90 mm. The length of the right kidney was between 55.50-125.0 mm, for female being 55.50-108.40 mm, and for male 62.04-125.0 mm. The width of the left kidney in the renal hillum was found to be between 15.54-41.10 mm, for female being between 15.54-31.0 mm, and for male between 16.19-41.10 mm. The thickness of the left kidney in the renal hillum was found to be between 40.0-75.80 mm, with the female being 44.02-71.02 mm, and the male between 40.0-75.80 mm. The right kidney thickness in the renal hillum was found to be between 41.67-82.36 mm, for female being between 41.67-60.27 mm and for male 43.89-82.36 mm.

Download Full-text

Relative length of human kidney as more precise measuring of normal kidney

Medicinski pregled ◽

10.2298/mpns1012784v ◽

2010 ◽

Vol 63 (11-12) ◽

pp. 784-787 ◽

Cited By ~ 1

Author(s):

Slobodan Vlajkovic ◽

Rade Cukuranovic ◽

Marija Dakovic-Bjelakovic ◽

Goran Ilic ◽

Tijana Jaksic ◽

...

Keyword(s):

Kidney Development ◽

Left Kidney ◽

Body Height ◽

Relative Length ◽

The Body ◽

Kidney Length ◽

Significant Difference ◽

The Absolute ◽

The Right ◽

Renal Length

Introduction. Malformations in kidney development and kidney diseases are accompanied with changes in their size. For kidney evaluation in clinical practice, the kidney length is the most widely used measurement, since it provides the most precise results and it is easy to perform. Recently, the measurement of relative renal length has become more preferable as it takes into account the body height. The aim of this study was to measure both the absolute and relative length of normal cadaveric kidneys according to the body height, sex and age. Material and methods. In this study, we examined 95 adult cadaveric kidneys, without renal and vascular impairment, their age ranging from 23-87 years. To determine the period of the most abundant changes in kidney length, we separated them into a 10-year range. The relative renal length was calculated using the kidney length anybody height ratio (kidney/body ratio). Results. The absolute and relative length of left kidney in males was longer than the right one, with a statistically significant correlation. In females, the left kidney length was also longer than the right one, however, without a statistical significance. In contrast to the absolute length, the relative length of both kidneys did not show a significant difference between sexes, and did not manifest a significant decrease with age. There was a significant correlation between the kidney length and the subject?s height. Conclusion. The relative renal length represents kidney size better than the absolute renal length because it eliminates sex and height differences until the age of 59 year. From the seventh decade of life, there is a significant decrease in both the absolute and relative renal length.

Download Full-text

CASE REPORT: SURGICAL MANAGEMENT OF LUMBAR COMPRESSION FRACTURE

Neurologico Spinale Medico Chirurgico ◽

10.15562/nsmc.v1i4.131 ◽

2019 ◽

Vol 1 (4) ◽

Author(s):

Yustinus Robby Budiman Gondowardojo ◽

Tjokorda Gde Bagus Mahadewa

Keyword(s):

Spinal Cord ◽

Left Lung ◽

Lumbar Vertebrae ◽

Compression Fracture ◽

High Mobility ◽

Early Mobilization ◽

Cord Injury ◽

Cardiothoracic Surgeon ◽

The Right

The lumbar vertebrae are the most common site for fracture incident because of its high mobility. The spinal cord injury usually happened as a result of a direct traumatic blow to the spine causing fractured and compressed spinal cord. A 38-year-old man presented with lumbar spine’s compression fracture at L2 level. In this patient, decompression laminectomy, stabilization, and fusion were done by posterior approach. The operation was successful, according to the X-Ray and patient’s early mobilization. Pneumothorax of the right lung and pleural effusion of the left lung occurred in this patient, so consultation was made to a cardiothoracic surgeon. Chest tube and WSD insertion were performed to treat the comorbidities. Although the patient had multiple trauma that threat a patient’s life, the management was done quickly, so the problems could be solved thus saving the patient’s life. After two months follow up, the patient could already walk and do daily activities independently.

Download Full-text

STUDY OF RADIATION CHARACTERISTICS THE RENAL FUNCTION IN PATIENTS WITH TYPE 2 DIABETES

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2014.2.12 ◽

2014 ◽

pp. 73-77

Author(s):

Van Chuong Nguyen ◽

Thi Kim Anh Nguyen

Keyword(s):

Type 2 Diabetes ◽

Renal Function ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Filtration Rate ◽

Disease Duration ◽

Left Kidney ◽

Cross Sectional ◽

The Right

Background: A Research glomerular filtration rate (GFR) of 61 patients with type 2 diabetes mellitus with renal scanning 99mTc-DTPA glomerular filtration rate at the hospital 175. Objective: (1) To study characteristics of imaging of renal function. (2) Understanding the relationship between GFR with blood sugar, HbA1c, blood pressure and albuminuria in patients with type 2 diabetes. Methods: Descriptive, prospective, cross-sectional study. Clinical examination, Clinical tests and 99mTc-DTPA GFR gamma - camera renography for patients. Result: GFR of the study group was 75,4 ± 22,3 ml/phut/1,73m2, the left kidney was 35,0 ± 13,0 is lower than the right kidney and 39,8 ± 11,9; p <0,01. There is no correlation between GFR with blood glucose and HbA1c, the risk of reduced GFR in hypertensive group associated is OR = 6,5 with p<0,01; albuminuria (+) is OR = 4,2 with p <0,01; and disease duration > 10 years is OR = 3,5 with p <0.01. Conclusion: GFR of the left kidneys is lower than the right kidney; correlation decreased GFR associated with hypertension, albuminuria and disease duration. Keywords: GFR, diabetes, albuminuria

Download Full-text

1003 A Case of Tunnel-Vision in Upper Renal Tract Imaging: The Invisible Gorilla

British Journal of Surgery ◽

10.1093/bjs/znab134.345 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

M Swamad ◽

M K Quraishi ◽

S Ahmed

Keyword(s):

Renal Mass ◽

Left Kidney ◽

Interesting Case ◽

Ct Scans ◽

Renal Ultrasound ◽

Ultrasound Scan ◽

Surgical Team ◽

Tunnel Vision ◽

Impact Patient Care ◽

The Right

Abstract We present an interesting case of a 70-year-old female who presented with haematuria on the suspected cancer pathway. Renal ultrasound showed a vascular renal mass on her right kidney measuring 8x7cm with an unremarkable left kidney. She underwent a laparoscopic radical nephrectomy following confirmation of an 8cm renal mass in the right kidney on the contrasted staging CT scan with a repeat review at the multidisciplinary meeting. Post-operatively a subsequent review of the pre-operative CT and ultrasound scan, showed an incidental large left(contralateral) upper quadrant retroperitoneal fatty mass sized 15x10cm, displacing the stomach and spleen. Further investigation in the form of an MRI Abdomen excluded features of a liposarcoma, resulting in the diagnosis of a large retroperitoneal lipoma. This case highlights the significance of selective attention in imaging interpretation. We believe this to be a prime example of the level of meticulousness required as fat-rich tissues have low attenuation on CT-scans, which can be easily missed out. A cautious multi-clinician interpretation of scans should be performed to avoid missing potentially sinister pathology which would impact patient care dramatically. This case has led to more thorough review of future pre-operative imaging by the operating surgical team.

Download Full-text

Ex Vivo Repair of a Renal Artery Saccular Aneurysm in a Living-Nonrelated Donor and Subsequent Successful Kidney Transplantation

Vascular and Endovascular Surgery ◽

10.1177/1538574418770104 ◽

2018 ◽

Vol 52 (6) ◽

pp. 455-458

Author(s):

Rogerio A. Muñoz-Vigna ◽

Javier E. Anaya-Ayala ◽

Juan N. Ramirez-Robles ◽

Daniel Nuño-Diaz ◽

Sandra Olivares-Cruz

Keyword(s):

Kidney Transplantation ◽

Renal Artery ◽

Ex Vivo ◽

Incidental Finding ◽

Left Kidney ◽

Renal Arteries ◽

Saccular Aneurysm ◽

Preoperative Imaging ◽

The Right ◽

Stage Renal Disease

The use of kidney grafts with aneurysmal disease involving the renal arteries for transplantation is very uncommon and relatively controversial. We herein present the case of a 52-year-old woman who volunteered to become a living-nonrelated donor; during the preoperative imaging workup, a computed tomography angiography revealed a 1.5-cm saccular aneurysm in the left kidney, while the contralateral renal artery was normal. We decided to utilize the left kidney for a 25-year-old male patient with end-stage renal disease, and following the ex vivo repair using the recipient epigastric vessels and saphenous veins, we completed the transplantation in the right pelvic fossa. The postoperative period was uneventful, and at 8 months from the surgery, the graft remains functional. The surgical repair of renal artery aneurysms followed by immediate kidney transplantation is a safe technique and an effective replacement therapy for recipients. The incidental finding of isolated aneurysmal disease in renal arteries should not exclude graft potential availability for transplantation following repair.

Download Full-text

Laparoscopic transposition for crossing vessels (vascular hitch) in pure extrinsic pelvic-ureteric junction obstruction: a successful case report of a 2-year-old infant with horseshoe kidney

Surgical Case Reports ◽

10.1186/s40792-021-01190-y ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Satoshi Ieiri ◽

Kouji Nagata

Keyword(s):

Laparoscopic Surgery ◽

Left Kidney ◽

Horseshoe Kidney ◽

Renal Scintigraphy ◽

Multicystic Dysplastic Kidney ◽

Extrinsic Compression ◽

Dysplastic Kidney ◽

Renal Vessels ◽

The Right ◽

Crossing Vessels

Abstract Background Pediatric hydronephrosis induced by pelvic-ureteric junction obstruction (PUJO) is treated by dismembered pyeloplasty (DP) via open and laparoscopic surgery. The etiology of PUJO involves both intrinsic stenosis and extrinsic compression of crossing vessels (CVs). PUJO owing to CVs is also treated by DP, as there is no consensus concerning this vascular condition. We encountered a 2-year-old infant with pure extrinsic PUJO combined with horseshoe kidney who successfully underwent laparoscopic transposition for CVs (vascular hitch). Case presentation A 2-year-old boy was prenatally diagnosed with left multicystic dysplastic kidney (MDCK) and right hydronephrosis and received a definitive diagnosis after birth. At 6 months old, renal scintigraphy revealed a non-functioning pattern in the left kidney and an obstructive pattern in the right, showing no response to furosemide loading. The patient also had recurrent urinary tract infection, and his right hydronephrosis gradually worsened. We decided to perform surgery for the right PUJO. Preoperative enhanced computed tomography detected three right renal vessels independently branching from the abdominal aorta. The middle renal vessels were located at the ventral side of the pelvis and coincident with the site of PUJO. These vessels were suspected of being CVs. The patient underwent laparoscopic surgery electively. A 5-mm trocar was inserted at the umbilicus for a 5-mm, 30° rigid scope. Two additional ports were then inserted under laparoscope inspection. The dilated right pelvis and CVs were detected after ascending colon mobilization. To confirm the pathogenesis of PUJO, the CVs were dissected and taped. After taping the CVs, an intraoperative diuretic test was performed using furosemide loading. Peristalsis of the right ureter was recognized, and the extrinsic PUJO owing to the CVs was definitively confirmed. We therefore performed transposition for the CVs (vascular hitch procedure). The CVs were mobilized in the cranial direction and those were wrapped by dilated pelvis. The post-operative course was uneventful. The renal scintigraphy findings improved and showed a favorable response of furosemide loading. Conclusions The laparoscopic vascular hitch procedure is minimally invasive and effective for extrinsic PUJO due to CVs. Anastomotic stricture after Anderson and Hynes DP can be prevented by appropriate patient selection.

Download Full-text